Individual
MRS. IVY REBECCA KOWALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1100 52ND ST SE, KENTWOOD, MI 49508-6008
(616) 304-3095
Mailing address
1100 52ND ST SE, KENTWOOD, MI 49508-6008
(616) 304-3095
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401017786
MI
101YP2500X
Professional Counselor
6401017786
MI
Other
Enumeration date
03/15/2015
Last updated
04/30/2022
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