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Individual
DR. MARK J MACGOWAN
Active
Individual
DR. MARK J MACGOWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
SW3871
FL
Other
Enumeration date
10/02/2018
Last updated
10/08/2018
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