Healthcare Provider Details

I. General information

NPI: 1952085177
Provider Name (Legal Business Name): GABRIELLE NICOLE KOWALSKI OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2023
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 IRVING ST NW FL 1
WASHINGTON DC
20010-2921
US

IV. Provider business mailing address

1215 E WEST HWY APT 1602
SILVER SPRING MD
20910-6282
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-1760
  • Fax:
Mailing address:
  • Phone: 302-547-6258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberOT210002219
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: