Provider Demographics
NPI:1790221604
Name:WOJCIK, CHLOE CHRISTINE (BA)
Entity Type:Individual
Prefix:MISS
First Name:CHLOE
Middle Name:CHRISTINE
Last Name:WOJCIK
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:893 SCENIC TRL
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-6400
Mailing Address - Country:US
Mailing Address - Phone:989-619-3674
Mailing Address - Fax:
Practice Address - Street 1:990 GARFIELD WOODS DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-5160
Practice Address - Country:US
Practice Address - Phone:231-668-4909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician