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General NPI Number Information
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NPI Number | 1477528685
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Entity Type | Individual
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Provider Name | NANCY L. WOHL LCSW, MA, CGP
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Gender | Female
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11109 76TH RD SUITE #E5
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City | FOREST HILLS
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State | NY
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Zip | 11375-6424
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Country | US
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Telephone | 718-357-0707
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Fax | 718-357-4455
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Provider Business Mailing Address
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Address Line | 18311A 58TH AVE
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-2208
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Country | US
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Telephone | 718-357-0707
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Fax | 718-357-4455
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R058061
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License Number State | NY
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