Individual
COLLEEN M KOWALKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
8150 N 61ST AVE, APT 2120, GLENDALE, AZ 85302-6764
(623) 261-8770
Mailing address
8150 N 61ST AVE, APT 2120, GLENDALE, AZ 85302-6764
(623) 261-8770
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC12790
AZ
103TC0700X
Clinical Psychologist
Primary
4545
AZ
Other
Enumeration date
12/26/2007
Last updated
02/10/2015
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