Provider Demographics
NPI:1285792077
Name:WOJNIAK, EDWARD JOHN JR (PHD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JOHN
Last Name:WOJNIAK
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3620 N. HIGH STREET
Mailing Address - Street 2:SUITE 209
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214
Mailing Address - Country:US
Mailing Address - Phone:614-268-3939
Mailing Address - Fax:614-269-3949
Practice Address - Street 1:3620 N. HIGH STREET
Practice Address - Street 2:SUITE 209
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3643
Practice Address - Country:US
Practice Address - Phone:614-268-3939
Practice Address - Fax:614-269-3949
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5218103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist