Individual
SUSAN WILDERMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, PD(MFT), LPC
Contact information
Practice address
512 CLINTON AVE, BELFORD, NJ 07718-1217
(732) 895-7009
(732) 787-3268
Mailing address
512 CLINTON AVE, BELFORD, NJ 07718-1217
(732) 895-7009
(732) 787-3268
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00357000
NJ
Other
Enumeration date
01/19/2008
Last updated
01/19/2008
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