Provider Demographics
NPI:1871939702
Name:NOWAKOWSKI, ANDREA LUCIA
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:LUCIA
Last Name:NOWAKOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4147 PALM FOREST DR S
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-5711
Mailing Address - Country:US
Mailing Address - Phone:954-709-0850
Mailing Address - Fax:
Practice Address - Street 1:4147 PALM FOREST DR S
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-5711
Practice Address - Country:US
Practice Address - Phone:954-709-0850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-19
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst