Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 20319 | TX |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 9873 | TX |
N | 101YP1600X | Pastoral Counselor | 123111 | TX |
NPI | 1306144845 |
---|---|
Provider Name | Daniel Gowan |
First Address | Plano, TX 75093-5164 |
Second Address | Plano, TX 75093-5164 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2011 |
Last Update Date | 08/03/2011 |