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1053160820
KENDRICKE DUVAUGHN WILSON
ROCKAWAY, NJ
NPI
1053160820
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-05-15
Last Update Date
2024-05-15
Business Address
KENDRICKE DUVAUGHN WILSON
25 W MAIN ST STE A
ROCKAWAY, NJ 07866-3435
Phone number: 973-625-1998
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Mailing Address
KENDRICKE DUVAUGHN WILSON
25 W MAIN ST STE A
ROCKAWAY, NJ 07866-3435
Phone number: 973-625-1998
Copy
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