Provider Demographics
NPI:1922395235
Name:KOWALCKY, CHRISTINE ELIZABETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ELIZABETH
Last Name:KOWALCKY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 HERRICK RD # 57
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2248
Mailing Address - Country:US
Mailing Address - Phone:781-609-7744
Mailing Address - Fax:
Practice Address - Street 1:129 HARVARD ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-6497
Practice Address - Country:US
Practice Address - Phone:617-834-4235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health