Individual
MS. YEDDI PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
372 GRAND AVE, 7A, LEONIA, NJ 07605-2256
(201) 920-5015
Mailing address
372 GRAND AVE, 7A, LEONIA, NJ 07605-2256
(201) 920-5015
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
44SL05242700
NJ
1041S0200X
School Social Worker
Primary
076492-1
NY
Other
Enumeration date
06/09/2010
Last updated
10/16/2010
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