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General NPI Number Information
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NPI Number | 1124106398
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Entity Type | Individual
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Provider Name | DAVID MICHAEL COWAN PHD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 04/11/2016
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Provider Practice Location Address
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Address Line | 43902 WOODWARD AVENUE SUITE 116
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48302-5021
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Country | US
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Telephone | 248-745-0425
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Fax | 248-745-0536
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Provider Business Mailing Address
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Address Line | PO BOX 430022
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City | PONTIAC
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State | MI
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Zip | 48343-0022
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Country | US
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Telephone | 248-745-0425
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Fax | 248-745-0536
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301005488
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 6301005488
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301005488
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 6301005488
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number | 6301005488
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | 6301005488
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License Number State | MI
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