Provider Information for 1093915399
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Ms. WYNANTE AUTHRINE SEWELL LPC, LMFT
Sex: Female
NPI: 1093915399
Last Updated: 2007-07-24
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1093915399 | ||||||||
| Enumeration Date | 2007-07-24 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1492 OCEAN AVE APARTMENT NO. C6 SEA BRIGHT, NJ 07760-2267 United States Phone: 717-679-7142 | Fax:732-383-5517 | ||||||||
| Primary Practice Address | 946 EDGEWOOD AVE TRENTON, NJ 08618-5304 United States Phone: 609-393-1626 | Fax:609-393-3113 | ||||||||
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