Provider Demographics
NPI:1225866213
Name:BAMBI A WALZER LCSW
Entity type:Organization
Organization Name:BAMBI A WALZER LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BAMBI
Authorized Official - Middle Name:A
Authorized Official - Last Name:WALZER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-718-0824
Mailing Address - Street 1:12 WOODCHUCK LN
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-5012
Mailing Address - Country:US
Mailing Address - Phone:732-718-0824
Mailing Address - Fax:732-676-7827
Practice Address - Street 1:12 WOODCHUCK LN
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-5012
Practice Address - Country:US
Practice Address - Phone:732-718-0824
Practice Address - Fax:732-676-7827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health