Provider Demographics
NPI:1316369218
Name:WOJTOWICZ, ELIZABETH ASHLEY
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ASHLEY
Last Name:WOJTOWICZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 BROOKS ST
Mailing Address - Street 2:#2
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-1733
Mailing Address - Country:US
Mailing Address - Phone:570-592-5619
Mailing Address - Fax:
Practice Address - Street 1:51 WATER ST
Practice Address - Street 2:SUITE 200
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4611
Practice Address - Country:US
Practice Address - Phone:617-923-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-11
Last Update Date:2014-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst