Doctor Name: | PATRICK CHARLES KOWALSKI |
NPI Number: | 1003133810 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LISW |
License Number: | I-07166 |
Business Practice Address: | 1519 Bonito Rd Sw Albuquerque, NM - 871054610 |
Business Phone Number: | 5054809423 |
Business Fax Number: | |
Mailing Address: | 1519 Bonito Rd Sw, ALBUQUERQUE |
State: | NM |
Postal Code: | 871054610 |
Phone Number: | 5054809423 |
Fax Number: | |
NPI Enumeration Date: | 05/03/2010 |
NPI Last Update Date: | 05/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I-07166 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |