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General NPI Number Information
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NPI Number | 1770982563
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Entity Type | Individual
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Provider Name | WANDA RAMOS DUCHATELLIER LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 08/18/2014
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Provider Practice Location Address
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Address Line | 726 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10003-9502
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Country | US
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Telephone | 212-998-4780
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Fax | 212-995-0496
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Provider Business Mailing Address
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Address Line | 1529 HAMMERSLEY AVE
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City | BRONX
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State | NY
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Zip | 10469-3142
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Country | US
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Telephone | 646-548-7044
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R048303-1
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License Number State | NY
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