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General NPI Number Information
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NPI Number | 1174986061
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Entity Type | Organization
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Legal Business Name | COURTNEY N WOWK LCSW LLC
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Dates
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Enumeration Date | 03/30/2016
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 7 OAK HILL TER SUITE 15
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City | SCARBOROUGH
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State | ME
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Zip | 04074-8996
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Country | US
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Telephone | 207-615-7338
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Fax |
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Provider Business Mailing Address
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Address Line | 7 OAK HILL TER SUITE 15
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City | SCARBOROUGH
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State | ME
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Zip | 04074-8996
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Country | US
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Telephone | 207-615-7338
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | COURTNEY N WOWK
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Credential | LCSW
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Telephone | 207-615-7338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC12908
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License Number State | ME
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