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General NPI Number Information
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NPI Number | 1104715754
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Entity Type | Individual
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Provider Name | KRISTEN ALICE WIMMER LSW
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Gender | Female
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 3 BARTLETT ST
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-8552
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Country | US
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Telephone | 848-932-1181
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Fax |
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Provider Business Mailing Address
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Address Line | 529 REMSEN AVE UNIT 529
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-2423
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Country | US
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Telephone | 732-491-5661
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL07143900
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License Number State | NJ
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