MR. Edward S Wallach, LCSW, PH.D.
NPI #1003238205 in Staten Island, New York
Provider Information
- NPI Number
- 1003238205
- Entity Type
- Individual
- Name
- MR. Edward S Wallach, LCSW, PH.D.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Social Worker - Clinical
- Credential
- LCSW, PH.D.
- Enumeration Date
- Jan 8, 2014
- Last Updated
- Jan 8, 2014
Practice Location
- Address
- 673 STEWART AVENUE
- City
- Staten Island
- State
- New York
- ZIP Code
- 10314
- Phone
- (718) 698-1795
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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