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General NPI Number Information
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NPI Number | 1245895424
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Entity Type | Organization
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Legal Business Name | THE WELL OF TRUTH, INC.
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Dates
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Enumeration Date | 05/03/2019
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Last Update Date | 05/03/2019
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Provider Practice Location Address
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Address Line | 105 N CAMBRIDGE ST
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City | MALVERNE
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State | NY
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Zip | 11565-2151
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Country | US
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Telephone | 516-887-4614
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Fax | 516-887-4686
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Provider Business Mailing Address
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Address Line | 105 N CAMBRIDGE ST
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City | MALVERNE
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State | NY
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Zip | 11565-2151
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Country | US
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Telephone | 516-887-4614
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Fax | 516-887-4686
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Authorized Official
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Title or Position | PRESIDENT/CEO/COUNSELOR
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Name | MR. PAUL AMMENDOLA
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Credential | LCSW
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Telephone | 516-887-4614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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