Provider Demographics
NPI:1821144189
Name:WILTSHIRE, DOROTHY B (MSW, LCSW, BCD)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:B
Last Name:WILTSHIRE
Suffix:
Gender:F
Credentials:MSW, LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2202
Mailing Address - Country:US
Mailing Address - Phone:201-538-4164
Mailing Address - Fax:704-921-1420
Practice Address - Street 1:668 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-2202
Practice Address - Country:US
Practice Address - Phone:201-538-4164
Practice Address - Fax:704-921-1420
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC14196106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist