Individual
MELISSA WISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
208 GATES AVE, MONTCLAIR, NJ 07042-1743
(917) 748-7104
Mailing address
208 GATES AVE, MONTCLAIR, NJ 07042-1743
(917) 748-7104
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05777700
NJ
Other
Enumeration date
02/15/2019
Last updated
02/15/2019
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