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General NPI Number Information
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NPI Number | 1912716085
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Entity Type | Individual
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Provider Name | MS. KOWO KESSELLY
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Gender | Female
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 119 S BURROWES ST STE 604
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City | STATE COLLEGE
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State | PA
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Zip | 16801-3864
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Country | US
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Telephone | 888-500-2067
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Fax | 617-649-8520
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Provider Business Mailing Address
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Address Line | 530 S 4TH ST
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City | DARBY
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State | PA
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Zip | 19023-3118
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Country | US
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Telephone | 267-701-6016
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 140971
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License Number State | PA
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