Provider Information for 1447428693
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Ms. REGINA GERARD KUJAWA LCSW
Sex: Female
NPI: 1447428693
Last Updated: 2024-03-07
Certification Date: 2024-03-07
Certification Date: 2024-03-07
Details
Name | Value | ||||||||||||||||
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NPI | 1447428693 | ||||||||||||||||
Enumeration Date | 2008-02-11 | ||||||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||||||
Sole Proprietor | YES | ||||||||||||||||
Status | Active | ||||||||||||||||
Mailing Address | PO BOX 751803 CHARLOTTE, NC 28275-1803 United States Phone: | Fax: | ||||||||||||||||
Primary Practice Address | 175 KIMEL PARK DR STE 100 WINSTON SALEM, NC 27103-6951 United States Phone: 336-718-3550 | Fax:336-277-1825 | ||||||||||||||||
Secondary Practice Address(es) | 1904 KELLO DR | ||||||||||||||||
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