Provider Demographics
NPI:1982350187
Name:DR. JENNIFER NOWAK, PLLC
Entity Type:Organization
Organization Name:DR. JENNIFER NOWAK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:REBEKAH
Authorized Official - Last Name:NOWAK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:267-980-8910
Mailing Address - Street 1:4 TERRY DR STE 17
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1838
Mailing Address - Country:US
Mailing Address - Phone:267-980-8910
Mailing Address - Fax:
Practice Address - Street 1:4 TERRY DR STE 17
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1838
Practice Address - Country:US
Practice Address - Phone:267-980-8910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty