Provider Demographics
NPI:1306185327
Name:PAZIAK, EWA HALINA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:EWA
Middle Name:HALINA
Last Name:PAZIAK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 BLACKBURN DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-8202
Mailing Address - Country:US
Mailing Address - Phone:706-364-1820
Mailing Address - Fax:706-364-1870
Practice Address - Street 1:522 BLACKBURN DR
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-8202
Practice Address - Country:US
Practice Address - Phone:706-364-1820
Practice Address - Fax:706-364-1870
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003772103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical