Provider Information for 1336624592
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AUGUSTA LYNN WELLINGTON LCSW "R"
Sex: Female
NPI: 1336624592
Last Updated: 2018-10-10
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1336624592 | ||||||||||||||||
| Enumeration Date | 2018-10-03 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 211 W 56TH ST APT 5J NEW YORK, NY 10019-4316 United States Phone: 917-763-2624 | Fax: | ||||||||||||||||
| Primary Practice Address | 211 W 56TH ST APT 5J NEW YORK, NY 10019-4316 United States Phone: 917-763-2624 | Fax: | ||||||||||||||||
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