Provider Demographics
NPI:1487981668
Name:WYJAD, PATRICIA M (LMSW)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:M
Last Name:WYJAD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 ALEXANDER ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-4000
Mailing Address - Country:US
Mailing Address - Phone:585-922-7758
Mailing Address - Fax:585-922-7246
Practice Address - Street 1:224 ALEXANDER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-4000
Practice Address - Country:US
Practice Address - Phone:585-922-7758
Practice Address - Fax:585-922-7246
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR081400-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical