Provider Demographics
NPI:1700554508
Name:KOWALSKI, MARISA RASHEL (LLMSW)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:RASHEL
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 KEYES DR
Mailing Address - Street 2:
Mailing Address - City:PARCHMENT
Mailing Address - State:MI
Mailing Address - Zip Code:49004-1493
Mailing Address - Country:US
Mailing Address - Phone:269-370-5241
Mailing Address - Fax:
Practice Address - Street 1:350 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-3800
Practice Address - Country:US
Practice Address - Phone:269-598-2837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-06
Last Update Date:2021-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68510914641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical