Doctor Name: | WILLIAM WETZEL |
NPI Number: | 1356700157 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 998 Crooked Hill Rd West Brentwood, NY - 117171019 |
Business Phone Number: | 6317614201 |
Business Fax Number: | 6317614184 |
Mailing Address: | 998 Crooked Hill Rd, WEST BRENTWOOD |
State: | NY |
Postal Code: | 117171019 |
Phone Number: | 6317614201 |
Fax Number: | 6317614184 |
NPI Enumeration Date: | 02/22/2016 |
NPI Last Update Date: | 02/22/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |