Provider Demographics
NPI:1588848865
Name:WOJTALEWICZ, MARIA P (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:P
Last Name:WOJTALEWICZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4337 NW 26TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-1638
Mailing Address - Country:US
Mailing Address - Phone:352-264-0511
Mailing Address - Fax:
Practice Address - Street 1:4337 NW 26TH TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-1638
Practice Address - Country:US
Practice Address - Phone:352-264-0511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-23
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7355103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL812404300Medicaid