Provider Demographics
NPI:1700178829
Name:KOWALSKI, VICTORIA CECYLIA (LSW)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:CECYLIA
Last Name:KOWALSKI
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 1:572 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17113-2640
Mailing Address - Country:US
Mailing Address - Phone:570-350-3354
Mailing Address - Fax:
Practice Address - Street 1:1100 S CAMERON ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-2547
Practice Address - Country:US
Practice Address - Phone:717-238-7662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-08
Last Update Date:2011-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW127027104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker