Provider Demographics
NPI:1457423030
Name:ZARKOWKSKI, GWEN (LSW)
Entity Type:Individual
Prefix:
First Name:GWEN
Middle Name:
Last Name:ZARKOWKSKI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 DRAKE LN
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1650
Mailing Address - Country:US
Mailing Address - Phone:215-538-7454
Mailing Address - Fax:215-914-1663
Practice Address - Street 1:5175 COLD SPRING CREAMERY RD
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-6228
Practice Address - Country:US
Practice Address - Phone:215-348-9640
Practice Address - Fax:215-914-1663
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW010775L101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health