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Individual

TAMMY COWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3200 RED RIVER ST STE 101, AUSTIN, TX 78705-2655
(512) 476-8857
Mailing address
13218 BROADMEADE AVE, AUSTIN, TX 78729-2818
(817) 925-6530

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
206220
LICENSE#
TX
Enumeration date
08/30/2006
Last updated
07/08/2007
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