Individual
ERIN ELIZABETH MICKELWAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
114 KINDERKAMACK RD, PARK RIDGE, NJ 07656-2126
(201) 391-1355
Mailing address
114 KINDERKAMACK RD, PARK RIDGE, NJ 07656-2126
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05879800
NJ
Other
Enumeration date
10/27/2022
Last updated
10/27/2022
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