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General NPI Number Information
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NPI Number | 1770106130
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Entity Type | Individual
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Provider Name | KELLY NEDELYA KOWALCHUK LSW
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Gender | Female
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Dates
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Enumeration Date | 05/20/2020
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 18 CAMPUS BLVD SUITE 100
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073
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Country | US
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Telephone | 610-585-6522
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Fax |
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Provider Business Mailing Address
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Address Line | 1724 BARKER CIR
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City | WEST CHESTER
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State | PA
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Zip | 19380-6188
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Country | US
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Telephone | 610-585-6522
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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 | 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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