Doctor Name: | MRS. GLORIA WYKA |
NPI Number: | 1770857344 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.S.W. |
License Number: | 44SC05425300 |
Business Practice Address: | 5 Madison St Pequannock, NJ - 074401403 |
Business Phone Number: | 9733103057 |
Business Fax Number: | |
Mailing Address: | 5 Madison St, PEQUANNOCK |
State: | NJ |
Postal Code: | 074401403 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/29/2012 |
NPI Last Update Date: | 02/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 44SC05425300 |
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 |