Healthcare Provider Details

I. General information

NPI: 1124382437
Provider Name (Legal Business Name): AARON THOMAS KOWALSKI PSC-B
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 07/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N COURT ST
VISALIA CA
93291-4918
US

IV. Provider business mailing address

201 N COURT ST
VISALIA CA
93291-4918
US

V. Phone/Fax

Practice location:
  • Phone: 559-627-2046
  • Fax: 559-627-9079
Mailing address:
  • Phone: 559-627-2046
  • Fax: 559-627-9079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: