MEDICARE: MS. ORLY JALOWSKI MS

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
1	101YM0800X	Mental Health Counselor	LC7605	MD

General Provider Information

NPI Number	:	1144623877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ORLY JALOWSKI MS

Provider Business Mailing Address
First Line	:	6411 ORCHARD AVE # 102
Second Line	:
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-4712
Country	:	US
Telephone Number	:	301-892-6549
Fax Number	:

Provider Business Practice Location Address
First Line	:	6411 ORCHARD AVE # 102
Second Line	:
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-4712
Country	:	US
Telephone Number	:	301-892-6549
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2014
Last Update Date	:	10/12/2018

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