Individual
ANNA COWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 QUARTZ DR, VILLA RICA, GA 30180-3255
(770) 812-3452
Mailing address
101 QUARTZ DR, VILLA RICA, GA 30180-3255
(770) 812-3452
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
006717
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006717
—
GA
Enumeration date
12/03/2019
Last updated
12/03/2019
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