Provider Demographics
NPI:1730513326
Name:LEWANDOSKI, PATRICIA M (MS BCBA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:LEWANDOSKI
Suffix:
Gender:F
Credentials:MS BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 E HAMPTON RD STE 7
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:CT
Mailing Address - Zip Code:06447-1447
Mailing Address - Country:US
Mailing Address - Phone:860-295-0366
Mailing Address - Fax:860-295-0377
Practice Address - Street 1:3 E HAMPTON RD STE 7
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:CT
Practice Address - Zip Code:06447-1447
Practice Address - Country:US
Practice Address - Phone:860-295-0366
Practice Address - Fax:860-295-0377
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-13-12805103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst