Individual provider · Type 1 NPI

Winston Wallace

Mental Health Counselor · St. Albans, NY

NPI number 1750639928 Active

Practice location

11454 198th St
St. Albans, NY 11412-2821

Call (718) 506-6968 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1750639928

Winston Wallace's National Provider Identifier is 1750639928, issued on Aug 20, 2012. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in St. Albans, NY. The record was last updated on Aug 20, 2012.