Provider Demographics
NPI:1306714688
Name:WESLEY, SPRING W (PHD)
Entity type:Individual
Prefix:PROF
First Name:SPRING
Middle Name:W
Last Name:WESLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 MILLBURN AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3726
Mailing Address - Country:US
Mailing Address - Phone:862-236-7273
Mailing Address - Fax:
Practice Address - Street 1:2040 MILLBURN AVE STE 102-627
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3726
Practice Address - Country:US
Practice Address - Phone:862-236-7273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty