| Organization Name: | HEATHER WILDER DODDS LCSW,LLC |
| NPI Number: | 1003188673 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HEATHER DODDS (COUNSELOR) |
| Mailing Address: | 628 Shrewsbury Ave Ste H Tinton Falls |
| State: | NJ US |
| Postal Code: | 077014912 |
| Phone Number: | 9084479226 |
| Fax Number: | |
| NPI Enumeration Date: | 01/30/2012 |
| NPI Last Update Date: | 01/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 44SC05283400 |
| 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 |