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General NPI Number Information
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NPI Number | 1073180469
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Entity Type | Organization
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Legal Business Name | PRECIOUS WHOLENESS LCSW PLLC
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Dates
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Enumeration Date | 06/05/2021
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Last Update Date | 06/05/2021
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Provider Practice Location Address
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Address Line | 1422 ALPHA ST
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City | ELMONT
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State | NY
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Zip | 11003-2403
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Country | US
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Telephone | 917-447-3642
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Fax |
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Provider Business Mailing Address
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Address Line | 1422 ALPHA ST
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City | ELMONT
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State | NY
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Zip | 11003-2403
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Country | US
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Telephone | 917-447-3642
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA R. WILLIAMS
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Credential | LCSW
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Telephone | 917-447-3642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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