Provider Demographics
NPI:1497297857
Name:PAXTON-MIERZEJEWSKI, ADELE
Entity Type:Individual
Prefix:
First Name:ADELE
Middle Name:
Last Name:PAXTON-MIERZEJEWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADELE
Other - Middle Name:
Other - Last Name:PAXTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 208
Mailing Address - Street 2:
Mailing Address - City:HADLYME
Mailing Address - State:CT
Mailing Address - Zip Code:06439-0208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:132 GROVE ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-5047
Practice Address - Country:US
Practice Address - Phone:860-482-5558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional