Healthcare Provider Details

I. General information

NPI: 1326445925
Provider Name (Legal Business Name): JENNIFER KAMALA KOWALSKI MSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2014
Last Update Date: 10/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1281 GUMWOOD DR
COLUMBUS OH
43229-4424
US

IV. Provider business mailing address

1281 GUMWOOD DR
COLUMBUS OH
43229-4424
US

V. Phone/Fax

Practice location:
  • Phone: 614-893-9887
  • Fax:
Mailing address:
  • Phone: 614-893-9887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1600352
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: