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NPI Code Detail

MEDICARE: KELLY ROWE MS

MEDICARE: KELLY ROWE MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool PsychologistPPS-549075VA

General Provider Information

NPI Number : 1407430242
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY ROWE MS
Provider Business Mailing Address
First Line : 8270 WILLOW OAKS CORPORATE DR
Second Line :
City : FAIRFAX
State : VA
Zip : 22031-4530
Country : US
Telephone Number : 703-317-1473
Fax Number :
Provider Business Practice Location Address
First Line : 8270 WILLOW OAKS CORPORATE DR
Second Line :
City : FAIRFAX
State : VA
Zip : 22031-4530
Country : US
Telephone Number : 703-658-5676
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2021
Last Update Date : 12/19/2025

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