Provider Demographics
NPI:1063526911
Name:DOBROWOLSKI, KELLY ANN (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:DOBROWOLSKI
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:ANN
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:125 GARWOOD DR
Mailing Address - Street 2:GARWOOD ESTATES
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1502
Mailing Address - Country:US
Mailing Address - Phone:302-834-5334
Mailing Address - Fax:
Practice Address - Street 1:62 N CHAPEL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-2238
Practice Address - Country:US
Practice Address - Phone:302-738-3305
Practice Address - Fax:302-738-4103
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00008361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical