Provider Demographics
NPI:1184135972
Name:CHWALEK, CAROLYN MARIE (MMT, MT-BC, LCAT)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MARIE
Last Name:CHWALEK
Suffix:
Gender:F
Credentials:MMT, MT-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PROSPECT PARK W APT 3B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3779
Mailing Address - Country:US
Mailing Address - Phone:315-591-5939
Mailing Address - Fax:
Practice Address - Street 1:100 PROSPECT PARK W APT 3B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3779
Practice Address - Country:US
Practice Address - Phone:315-591-5939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist