Individual
KELLY WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
120 CHESTNUT ST, RIDGEWOOD, NJ 07450-2504
(201) 444-3550
Mailing address
11 HIGH ST APT 3R, NUTLEY, NJ 07110-1166
(201) 398-3038
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06505100
NJ
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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