Individual
GWEN ISLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
40 EISENHOWER DR, PARAMUS, NJ 07652-1404
(201) 870-1943
(201) 291-0888
Mailing address
79 DEERFIELD ST, WORCESTER, MA 01602-4348
(978) 505-9521
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06470900
NJ
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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