Most Relevant Information
Provider Data
| NPI Number: | 1003565052 |
| Provider Name: | TODD WICKERSHEIM LSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 44SL06472000 |
Most Important Dates
| Enumeration Date: | 03/18/2022 |
| Last Updated: | 03/18/2022 |
Provider Practice Location
126 CEDAR AVE
HACKENSACK
NJ
076012925
Practice Location Phone/Fax
| Phone: | 2015197950 |
| Fax: |
Provider Mailing Location
126 CEDAR AVE
HACKENSACK
NJ
076012925
Provider Mailing Phone/Fax
| Phone: | 2015197950 |
| Fax: |