Healthcare Provider Details

I. General information

NPI: 1578492575
Provider Name (Legal Business Name): MARIA KOWALSKY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8601 SIX FORKS RD STE 400
RALEIGH NC
27615-2965
US

IV. Provider business mailing address

8601 SIX FORKS RD STE 400
RALEIGH NC
27615-2965
US

V. Phone/Fax

Practice location:
  • Phone: 646-941-7645
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: