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General NPI Number Information
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NPI Number | 1285157172
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Entity Type | Individual
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Provider Name | JENNIFER REBEKAH NOWAK PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 07/21/2017
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Last Update Date | 01/31/2022
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Provider Practice Location Address
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Address Line | 4 TERRY DR STE 17
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City | NEWTOWN
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State | PA
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Zip | 18940-1838
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Country | US
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Telephone | 267-980-8910
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Fax |
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Provider Business Mailing Address
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Address Line | 18 SHELTON LN
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City | LANGHORNE
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State | PA
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Zip | 19047-1190
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Country | US
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Telephone | 215-266-0816
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS018308
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License Number State | PA
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