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NPI Code Detail

MEDICARE: RANDI MICHELLE COWAN

MEDICARE: RANDI MICHELLE COWAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1679140693
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDI MICHELLE COWAN
Provider Business Mailing Address
First Line : 3300 N INTERSTATE 35 STE 700
Second Line :
City : AUSTIN
State : TX
Zip : 78705-1874
Country : US
Telephone Number : 844-362-7943
Fax Number :
Provider Business Practice Location Address
First Line : 3300 N INTERSTATE 35 STE 700
Second Line :
City : AUSTIN
State : TX
Zip : 78705-1874
Country : US
Telephone Number : 844-362-7943
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2021
Last Update Date : 06/08/2021

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Directions to “ RANDI MICHELLE COWAN ” Practice Location

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