Provider Demographics
NPI:1710285374
Name:WISNIEWAKI, DEBORAH ANN (LMSW, CSSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANN
Last Name:WISNIEWAKI
Suffix:
Gender:F
Credentials:LMSW, CSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 LAKESHORE DRIVE EAST
Mailing Address - Street 2:DUNKIRK CITY SCHOOL DISTRICT #7
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048
Mailing Address - Country:US
Mailing Address - Phone:716-366-9300
Mailing Address - Fax:
Practice Address - Street 1:345 LAKESHORE DRIVE EAST
Practice Address - Street 2:DUNKIRK CITY SCHOOL DISTRICT #7
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048
Practice Address - Country:US
Practice Address - Phone:716-366-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066991-11041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool