Dwight Kidder, LCSW, LCAS
Social Worker, Clinical in Wilmington, NC. Individual provider (NPI-1).
NPI number1710742002
StatusActive
Last updated in NPPESFeb 16, 2024
Details
- NPI
- 1710742002
- Entity type
- Individual (NPI-1)
- Name
- Dwight Kidder
- Credential
- LCSW, LCAS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 16, 2024
- Certification date
- Feb 16, 2024
- Last updated
- Feb 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | C016703 | NC | Yes |
Practice location
3208 Oleander DrWilmington, NC 28403-0800
Phone 910-233-5663
Mailing address
444 Pheasant CtWilmington, NC 28403-2866
Phone 704-993-8067
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