Healthcare Provider Details

I. General information

NPI: 1871383364
Provider Name (Legal Business Name): KATIE KOWALSKI
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 WESTWOOD AVE
ANN ARBOR MI
48103-3551
US

IV. Provider business mailing address

306 WESTWOOD AVE
ANN ARBOR MI
48103-3551
US

V. Phone/Fax

Practice location:
  • Phone: 517-420-3414
  • Fax:
Mailing address:
  • Phone: 517-420-3414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851118569
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: