Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 44SC05448600 | NJ |
NPI | 1003194283 |
---|---|
Provider Name | Stephanie Wolfersberger |
First Address | Jersey City, NJ 07306 |
Second Address | Jersey City, NJ 07306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2011 |
Last Update Date | 13/06/2013 |