Healthcare Provider Details

I. General information

NPI: 1700380912
Provider Name (Legal Business Name): CHRISTA WOJCIK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 01/02/2020
Certification Date: 01/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 NW 3RD AVE
DELRAY BEACH FL
33444-2624
US

IV. Provider business mailing address

144 NW 3RD AVE
DELRAY BEACH FL
33444-2624
US

V. Phone/Fax

Practice location:
  • Phone: 347-885-7845
  • Fax:
Mailing address:
  • Phone: 347-885-7845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA15393
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: