Individual
BRIAN WAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
356 ENGLENOOK DR, DEBARY, FL 32713-1805
(386) 236-3200
Mailing address
1220 WILLIS AVE, DAYTONA BEACH, FL 32114-2810
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW12336
FL
Other
Enumeration date
08/18/2015
Last updated
08/18/2015
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