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General NPI Number Information
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NPI Number | 1023490364
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Entity Type | Organization
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Legal Business Name | WALK OF LIFE COUNSELING, LLC.
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Dates
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Enumeration Date | 06/23/2015
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Last Update Date | 06/23/2015
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Provider Practice Location Address
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Address Line | 196 HOPEWELL WERTSVILLE RD
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City | HOPEWELL
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State | NJ
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Zip | 08525-1008
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Country | US
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Telephone | 609-865-3305
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Fax |
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Provider Business Mailing Address
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Address Line | 196 HOPEWELL WERTSVILLE RD
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City | HOPEWELL
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State | NJ
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Zip | 08525-1008
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Country | US
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Telephone | 609-865-3305
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MISS KATHY L WALKER
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Credential | MA, NCC, LPC
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Telephone | 609-865-3305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00426100
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License Number State | NJ
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