Individual
AMANDA GOWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4812 NE WINFIELD CIR, LAWTON, OK 73507-6121
(580) 730-1520
Mailing address
143 REMOTE STREET, OKLAHOMA CITY, OK 73102
(580) 730-1520
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
0001082
—
106H00000X
Marriage & Family Therapist
Primary
11404
OK
106H00000X
Marriage & Family Therapist
57259
CA
Other
Enumeration date
01/06/2009
Last updated
07/10/2023
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