Provider Demographics
NPI:1477033538
Name:KRWAWICZ, JACQEULYN ANN (BSW)
Entity Type:Individual
Prefix:MRS
First Name:JACQEULYN
Middle Name:ANN
Last Name:KRWAWICZ
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:MS
Other - First Name:JACQUELYN
Other - Middle Name:ANN
Other - Last Name:MCGARRITY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2935 S CARLISLE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-4906
Mailing Address - Country:US
Mailing Address - Phone:215-880-4258
Mailing Address - Fax:
Practice Address - Street 1:2935 S CARLISLE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-4906
Practice Address - Country:US
Practice Address - Phone:215-880-4258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker