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General NPI Number Information
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NPI Number | 1871968446
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Entity Type | Individual
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Provider Name | VICTORIA HELEN WACHA PHD
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Gender | Female
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Dates
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Enumeration Date | 12/08/2015
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 163 ENGLE STREET BUILDING 2
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City | ENGLEWOOD
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State | NJ
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Zip | 07631
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Country | US
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Telephone | 201-350-7350
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Fax |
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Provider Business Mailing Address
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Address Line | 6 SKYLINE DR
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-1814
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Country | US
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Telephone | 347-699-6338
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 35S100538300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 35S100538300
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35S100538300
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License Number State | NJ
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