Individual
TODD WICKERSHEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
126 CEDAR AVE, HACKENSACK, NJ 07601-2925
(201) 519-7950
Mailing address
126 CEDAR AVE, HACKENSACK, NJ 07601-2925
(201) 519-7950
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06472000
NJ
Other
Enumeration date
03/18/2022
Last updated
03/18/2022
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