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General NPI Number Information
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NPI Number | 1699463539
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Entity Type | Organization
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Legal Business Name | ROWAN THERAPY COLLECTIVE, LLC
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Dates
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Enumeration Date | 04/28/2023
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 720 KATER ST APT 1F
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City | PHILADELPHIA
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State | PA
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Zip | 19147-2075
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Country | US
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Telephone | 717-745-6119
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Fax |
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Provider Business Mailing Address
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Address Line | 720 KATER ST APT 1F
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City | PHILADELPHIA
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State | PA
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Zip | 19147-2075
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Country | US
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Telephone | 717-745-6119
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KYRA L PAULES
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Credential | LSW
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Telephone | 717-712-3712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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