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General NPI Number Information
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NPI Number | 1144829367
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Entity Type | Individual
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Provider Name | JODY MOWREY PSYD LMHC RN
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Gender | Male
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Dates
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Enumeration Date | 10/19/2020
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 9466 NAVARRE PKWY STE C
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City | NAVARRE
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State | FL
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Zip | 32566-2948
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Country | US
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Telephone | 850-308-7292
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Fax |
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Provider Business Mailing Address
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Address Line | 4206 SPANISH TRAIL PL
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City | PENSACOLA
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State | FL
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Zip | 32504-8561
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Country | US
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Telephone | 185-086-0694
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH18350
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License Number State | FL
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