Provider Demographics
NPI:1467691477
Name:PAWLAK, MARIA ANASTASIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ANASTASIA
Last Name:PAWLAK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:STACEY
Other - Middle Name:A
Other - Last Name:PAWLAK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2924 CHIPPEWA TRL NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52411-7714
Mailing Address - Country:US
Mailing Address - Phone:319-356-2198
Mailing Address - Fax:
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:WOMEN'S WELLNESS & COUNSELING SERVICE
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-384-8718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-13
Last Update Date:2017-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001070103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical