Healthcare Provider Details

I. General information

NPI: 1114446663
Provider Name (Legal Business Name): CHELSEA GRZECHOWIAK MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N HIATUS RD STE 160161
PEMBROKE PINES FL
33026-3097
US

IV. Provider business mailing address

250 W SAMPLE ROAD APT D-126
POMPANO BEACH FL
33064
US

V. Phone/Fax

Practice location:
  • Phone: 954-333-8787
  • Fax: 954-333-8621
Mailing address:
  • Phone: 716-785-0899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: