Individual
JOSEPH F GAZARKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
1411 S. WOODLAND AVENUE, SUITE B, MICHIGAN CITY, IN 46360-7170
(219) 763-1499
(219) 764-7025
Mailing address
1411 S. WOODLAND AVENUE, SUITE B, MICHIGAN CITY, IN 46360-7170
(219) 879-8580
(219) 764-7025
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042249A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200958610
—
IN
Enumeration date
10/06/2009
Last updated
04/30/2012
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