Individual
KELLI ROSE SEMBOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3 KENSINGTON SQ, NEW KENSINGTON, PA 15068-6443
(878) 847-7179
Mailing address
3 KENSINGTON SQ, NEW KENSINGTON, PA 15068-6443
(878) 847-7179
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07211983
—
PA
Enumeration date
04/18/2019
Last updated
04/18/2019
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