Provider Demographics
NPI:1588387021
Name:MUSIELEWICZ, SANDRA R (LCSW)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:R
Last Name:MUSIELEWICZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2841 FM 1155 S
Mailing Address - Street 2:
Mailing Address - City:CHAPPELL HILL
Mailing Address - State:TX
Mailing Address - Zip Code:77426-6055
Mailing Address - Country:US
Mailing Address - Phone:713-367-8903
Mailing Address - Fax:
Practice Address - Street 1:2841 FM 1155 S
Practice Address - Street 2:
Practice Address - City:CHAPPELL HILL
Practice Address - State:TX
Practice Address - Zip Code:77426-6055
Practice Address - Country:US
Practice Address - Phone:713-367-8903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX680322255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty