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General NPI Number Information
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NPI Number | 1760134316
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Entity Type | Organization
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Legal Business Name | REGINA KUJAWA LCSW PLLC
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Dates
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Enumeration Date | 01/25/2022
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 1175 REVOLUTION MILL DR STE 29-2
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City | GREENSBORO
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State | NC
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Zip | 27405-5079
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Country | US
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Telephone | 336-554-3291
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Fax |
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Provider Business Mailing Address
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Address Line | 5603B W FRIENDLY AVE # 256
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City | GREENSBORO
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State | NC
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Zip | 27410-4213
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Country | US
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Telephone | 336-554-3291
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REGINA KUJAWA
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Credential | LCSW
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Telephone | 336-554-3291
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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 |
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License Number State |
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