Provider Demographics
NPI:1639984255
Name:WOJCINSKI, CRYSTAL LYN
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LYN
Last Name:WOJCINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6733 NORTHCOTE AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-1722
Mailing Address - Country:US
Mailing Address - Phone:219-775-5835
Mailing Address - Fax:
Practice Address - Street 1:14813 101ST AVE
Practice Address - Street 2:
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311
Practice Address - Country:US
Practice Address - Phone:219-319-1523
Practice Address - Fax:800-513-7773
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician