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Organization
LETS TALK WELLNESS COUNSELING PSYCHIATRIC NP SERVICES
Active
Organization
LETS TALK WELLNESS COUNSELING PSYCHIATRIC NP SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANIQUA N WILSON (PSYCHIATRIC NURSE PRACTITIONER)
(917) 417-4649
Entity
Organization
Contact information
Practice address
131 WICKHAM AVE, MIDDLETOWN, NY 10940-3714
(347) 908-2797
Mailing address
131 WICKHAM AVE, MIDDLETOWN, NY 10940-3714
(347) 908-2797
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/04/2022
Last updated
12/12/2023
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