Individual
MS. ANN M WAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
31 THURBER DR, WATERLOO, NY 13165-1600
(315) 539-1980
(315) 539-1054
Mailing address
31 THURBER DR, WATERLOO, NY 13165-1600
(315) 539-1980
(315) 539-1054
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
070407
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070407
—
NY
Enumeration date
08/29/2006
Last updated
07/08/2007
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