Doctor Name: | MS. WENDY ANN MASON |
NPI Number: | 1558639930 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW-R |
License Number: | 75334 |
Business Practice Address: | 24 Walden Gln Ballston Lake, NY - 120199234 |
Business Phone Number: | 5188991585 |
Business Fax Number: | |
Mailing Address: | 24 Walden Gln, BALLSTON LAKE |
State: | NY |
Postal Code: | 120199234 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/13/2011 |
NPI Last Update Date: | 12/13/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | 75334 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |