Provider Demographics
NPI:1013682079
Name:KRAWIEC, AUDREY (MS)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:KRAWIEC
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 STAFFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-2542
Mailing Address - Country:US
Mailing Address - Phone:860-416-8205
Mailing Address - Fax:
Practice Address - Street 1:1098 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4705
Practice Address - Country:US
Practice Address - Phone:860-589-6433
Practice Address - Fax:860-589-6442
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor