Individual
ROBERT J WALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LICSW
Contact information
Practice address
97 CARDIGAN RD, TEWKSBURY, MA 01876-1206
(978) 590-8172
Mailing address
97 CARDIGAN RD, TEWKSBURY, MA 01876-1206
(978) 590-8172
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
106228
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106228
LICENSED INDEPENDENT CLINICAL SOCIAL WORKER
MA
Enumeration date
09/17/2018
Last updated
09/17/2018
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