Provider Demographics
NPI:1487812996
Name:MAUREEN WOZNIAK,MS,LPC, PC
Entity type:Organization
Organization Name:MAUREEN WOZNIAK,MS,LPC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:WOZNIAK
Authorized Official - Suffix:
Authorized Official - Credentials:MS,LPC
Authorized Official - Phone:912-398-8250
Mailing Address - Street 1:5302 FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4812
Mailing Address - Country:US
Mailing Address - Phone:912-398-8250
Mailing Address - Fax:912-352-4220
Practice Address - Street 1:5302 FREDERICK ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4812
Practice Address - Country:US
Practice Address - Phone:912-398-8250
Practice Address - Fax:912-352-4220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA075685958AMedicaid