Healthcare Provider Details

I. General information

NPI: 1780004390
Provider Name (Legal Business Name): DR. JULIE WOJCIK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2014
Last Update Date: 04/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 LAKESIDE AVE E
CLEVELAND OH
44114-1137
US

IV. Provider business mailing address

9585 HICKORY HILL DR
TWINSBURG OH
44087-1546
US

V. Phone/Fax

Practice location:
  • Phone: 216-523-8498
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberOH300644
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: