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General NPI Number Information
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NPI Number | 1295060523
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Entity Type | Individual
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Provider Name | LINDA A. VANWULFEN MA, MSW
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Gender | Female
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Dates
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Enumeration Date | 10/05/2009
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Last Update Date | 10/05/2009
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Provider Practice Location Address
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Address Line | 1250 ANDREWS CIR
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City | STARKE
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State | FL
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Zip | 32091-2132
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Country | US
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Telephone | 904-964-1540
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 421
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32170-0421
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Country | US
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Telephone | 386-290-2220
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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