Healthcare Provider Details

I. General information

NPI: 1861312274
Provider Name (Legal Business Name): ROBERT ANDREW COWAN RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 GRANT ST SE # 6205
DECATUR AL
35601-2511
US

IV. Provider business mailing address

215 GRANT ST SE
DECATUR AL
35601-2511
US

V. Phone/Fax

Practice location:
  • Phone: 938-286-2183
  • Fax: 938-286-2183
Mailing address:
  • Phone: 904-416-8517
  • Fax: 904-416-8517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number2826311
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: