Individual
PATTY WYCKOFF-FISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
I-04645
NM
1041S0200X
School Social Worker
Primary
264414
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
57276099
—
NM
Enumeration date
10/19/2006
Last updated
09/11/2025
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