Healthcare Provider Details

I. General information

NPI: 1790616209
Provider Name (Legal Business Name): CYNTHIA FRIEDA KOWALIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 SAWDUST RD STE 210
SPRING TX
77380-2947
US

IV. Provider business mailing address

719 SAWDUST RD STE 210
SPRING TX
77380-2947
US

V. Phone/Fax

Practice location:
  • Phone: 346-202-7570
  • Fax: 346-202-7571
Mailing address:
  • Phone: 346-202-7570
  • Fax: 346-202-7571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number94248
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: