Healthcare Provider Details

I. General information

NPI: 1346960614
Provider Name (Legal Business Name): ABBY WOJCIECHOWSKI LMFTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4505 FAIR MEADOWS LN STE 103
RALEIGH NC
27607-6449
US

IV. Provider business mailing address

1007 RIVER HILL DR
GREENVILLE NC
27858-8335
US

V. Phone/Fax

Practice location:
  • Phone: 984-204-1337
  • Fax:
Mailing address:
  • Phone: 252-917-1637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number12448A
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: