Individual
CARLY COWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
704 N OAK AVE, RM 20, ADA, OK 74820-3267
(580) 332-3001
(580) 332-3652
Mailing address
130 W 19TH ST, ADA, OK 74820-8202
(580) 332-3001
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/06/2012
Last updated
11/06/2012
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