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General NPI Number Information
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NPI Number | 1982065728
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Entity Type | Individual
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Provider Name | MENTWAB WUHIB PHD
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Gender | Female
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Dates
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Enumeration Date | 03/07/2016
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 1 ELM ST #4
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City | GREAT NECK
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State | NY
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Zip | 11021-1226
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Country | US
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Telephone | 917-388-0422
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Fax |
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Provider Business Mailing Address
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Address Line | 4370 KISSENA BLVD APT 14K
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City | FLUSHING
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State | NY
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Zip | 11355-3769
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Country | US
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Telephone | 917-388-0422
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0184521
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License Number State | NY
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