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Provider Information for 1932228806


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THEODOSIA R PACLAWSKYJ PHD


Sex: Female

NPI: 1932228806
Last Updated: 2023-04-28
Certification Date: 2023-04-24

Details

NameValue
NPI1932228806
Enumeration Date2007-03-29
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 204 QUAYSIDE CIR APT 502
MAITLAND, FL 32751-5778
United States

Phone: | Fax:
 
Primary Practice Address 707 N BROADWAY
BALTIMORE, MD 21205-1832
United States

Phone: 443-923-1886 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 103TM1800X - Psychologist - Intellectual & Developmental DisabilitiesPY9510