| NPI | 1295212561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY FLINT WALDRUP Owner 917-627-9782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC006688) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2018-07-19 |