Doctor Name: | MS. VICKI L WEIDMAN |
NPI Number: | 1003181454 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LCSW |
License Number: | SC05498400 |
Business Practice Address: | 7 Alpine Dr Perrineville, NJ - 085351125 |
Business Phone Number: | 2019131492 |
Business Fax Number: | |
Mailing Address: | 7 Alpine Dr, PERRINEVILLE |
State: | NJ |
Postal Code: | 085351125 |
Phone Number: | 2019131492 |
Fax Number: | |
NPI Enumeration Date: | 03/19/2012 |
NPI Last Update Date: | 01/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | SC05498400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |