| Doctor Name: | MS. WENDY ELLEN MITA |
| NPI Number: | 1144477480 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 44SC04931900 |
| Business Practice Address: | 51 John F Kennedy Pkwy Short Hills, NJ - 070782704 |
| Business Phone Number: | 2014886678 |
| Business Fax Number: | |
| Mailing Address: | 481 Hackensack Ave, HACKENSACK |
| State: | NJ |
| Postal Code: | 076016304 |
| Phone Number: | 2014886678 |
| Fax Number: | 2014886224 |
| NPI Enumeration Date: | 08/19/2008 |
| NPI Last Update Date: | 06/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 44SC04931900 |
| 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 |