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NPI Code Detail

MEDICARE: LAURA M JOWLY LCSW

MEDICARE: LAURA M JOWLY LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker078758NY

General Provider Information

NPI Number : 1114133139
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA M JOWLY LCSW
Provider Business Mailing Address
First Line : 6539 ANTHONY DR STE A
Second Line :
City : VICTOR
State : NY
Zip : 14564-1441
Country : US
Telephone Number : 585-398-8835
Fax Number : 585-398-7376
Provider Business Practice Location Address
First Line : 6539 ANTHONY DR STE A
Second Line :
City : VICTOR
State : NY
Zip : 14564-1441
Country : US
Telephone Number : 585-398-8835
Fax Number : 585-398-7376
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 07/26/2024

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Directions to “ LAURA M JOWLY LCSW” Practice Location

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