Antanaya I Wall

NPI #1447866413 in Wynantskill, New York

Provider Information

NPI Number: 1447866413
Entity Type: Individual
Name: Antanaya I Wall
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Enumeration Date: Sep 16, 2020
Last Updated: Sep 16, 2020

Practice Location

Address: 614 COOPER HILL RD
City: Wynantskill
State: New York
ZIP Code: 12198-2906
Phone: (518) 283-6500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X
Counselor - Professional — Professional	101YP2500X	Primary

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