Provider Demographics
NPI:1225494859
Name:TWARDZIK, CASSANDRA M (APSW)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:M
Last Name:TWARDZIK
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-3919
Mailing Address - Country:US
Mailing Address - Phone:608-755-8923
Mailing Address - Fax:608-758-5761
Practice Address - Street 1:20 E COURT ST
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-3919
Practice Address - Country:US
Practice Address - Phone:608-755-8923
Practice Address - Fax:608-758-5761
Is Sole Proprietor?:No
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI129581-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker