Provider Demographics
NPI:1972187078
Name:KORZENIEWSKI, JOLENE
Entity type:Individual
Prefix:
First Name:JOLENE
Middle Name:
Last Name:KORZENIEWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COURTNEY DR
Mailing Address - Street 2:
Mailing Address - City:SENECA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13148-2249
Mailing Address - Country:US
Mailing Address - Phone:315-651-2345
Mailing Address - Fax:
Practice Address - Street 1:1 COURTNEY DR
Practice Address - Street 2:
Practice Address - City:SENECA FALLS
Practice Address - State:NY
Practice Address - Zip Code:13148-2249
Practice Address - Country:US
Practice Address - Phone:315-651-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool