Individual
MR. JASON RYAN COWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
10300 HIGHWAY 69 S, TUSCALOOSA, AL 35405-9684
(205) 442-8207
Mailing address
PO BOX 741, FAYETTE, AL 35555-0741
(205) 442-8207
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2262C
AL
Other
Enumeration date
10/27/2018
Last updated
10/27/2018
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