MR. Winston Wallace
NPI #1750639928 in Saint Albans, New York
Provider Information
- NPI Number
- 1750639928
- Entity Type
- Individual
- Name
- MR. Winston Wallace
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Aug 20, 2012
- Last Updated
- Aug 20, 2012
Practice Location
- Address
- 11454 198TH ST
- City
- Saint Albans
- State
- New York
- ZIP Code
- 11412-2821
- Phone
- (718) 506-6968
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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