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Individual
RICHARD WOLAK
Active
Individual
RICHARD WOLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
103TF0000X
Family Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12345
NA
—
Enumeration date
01/17/2018
Last updated
06/16/2018
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