Provider Demographics
NPI:1992335244
Name:WUJCIK, ALFREDA A (LPC (LICENSED PROFES)
Entity type:Individual
Prefix:MS
First Name:ALFREDA
Middle Name:A
Last Name:WUJCIK
Suffix:
Gender:F
Credentials:LPC (LICENSED PROFES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 E BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201
Mailing Address - Country:US
Mailing Address - Phone:570-459-1920
Mailing Address - Fax:570-861-1358
Practice Address - Street 1:750 E BROAD STREET
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201
Practice Address - Country:US
Practice Address - Phone:570-459-1920
Practice Address - Fax:570-861-1358
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000269101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional