MEDICARE: ELIZABETH PAWLIKOWSKI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	2476	MA

General Provider Information

NPI Number	:	1023031663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH PAWLIKOWSKI

Provider Business Mailing Address
First Line	:	PO BOX 388
Second Line	:
City	:	SOUTH HADLEY
State	:	MA
Zip	:	01075-0388
Country	:	US
Telephone Number	:	413-538-9803
Fax Number	:

Provider Business Practice Location Address
First Line	:	97 WILLIAMSBURG RD
Second Line	:
City	:	WILLIAMSBURG
State	:	MA
Zip	:	01096-9721
Country	:	US
Telephone Number	:	413-538-9803
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	01/07/2020

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