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Provider Information for 1184383770


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DORIS WILAMOWSKI LCSW


Sex: Female

NPI: 1184383770
Last Updated: 2024-10-15
Certification Date: 2024-10-15

Details

NameValue
NPI1184383770
Enumeration Date2021-12-11
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 10420 QUEENS BLVD APT 22A
FOREST HILLS, NY 11375-3613
United States

Phone: 212-730-0303 | Fax:
 
Primary Practice Address 10420 QUEENS BLVD APT 22A
FOREST HILLS, NY 11375-3613
United States

Phone: 212-730-0303 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)5317Insurance private
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 103TP2701X - Psychologist - Group PsychotherapyNYPR16094
Yes 1041C0700X - Social Worker - ClinicalNY016094