Individual
NASTASSIA JADINE COWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1233 RHAWN ST APT 2, PHILADELPHIA, PA 19111-2637
(267) 579-6330
Mailing address
1233 RHAWN ST APT 2, PHILADELPHIA, PA 19111-2637
(267) 579-6330
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
—
—
103K00000X
Behavior Analyst
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/25/2024
Last updated
10/01/2024
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