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General NPI Number Information
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NPI Number | 1770634545
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Entity Type | Individual
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Provider Name | GLENN L WOJTOWICZ LCSW
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/14/2011
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Provider Practice Location Address
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Address Line | 151 FRIES MILL RD BLDG 2
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-2016
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Country | US
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Telephone | 856-270-2415
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Fax | 856-270-2403
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Provider Business Mailing Address
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Address Line | 527 FOREST EDGE
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City | DEPTFORD
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State | NJ
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Zip | 08096-2952
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Country | US
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Telephone | 856-686-0994
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05172400
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License Number State | NJ
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