Individual
CATHERINE CECILIA WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
15 HORSEBLOCK PL, FARMINGVILLE, NY 11738-1204
(631) 854-2571
(631) 854-2580
Mailing address
41 VIDONI DR, MOUNT SINAI, NY 11766-1736
(631) 473-6386
(631) 854-2580
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
043731-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00354807
—
NY
01
—
043731-1
LICENSE NUMBER
NY
01
—
5613055
CERTIFICATE NUMBER
NY
Enumeration date
11/28/2006
Last updated
07/08/2007
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