Provider Demographics
NPI:1750755062
Name:STRZELCZYK, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:STRZELCZYK
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 1:1480 HAMMOCK RIDGE RD APT 12204
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6391
Mailing Address - Country:US
Mailing Address - Phone:321-201-8885
Mailing Address - Fax:
Practice Address - Street 1:1480 HAMMOCK RIDGE RD APT 12204
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6391
Practice Address - Country:US
Practice Address - Phone:321-201-8885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst