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General NPI Number Information
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NPI Number | 1588936728
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Entity Type | Organization
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Legal Business Name | DAVID COWAN, PHD, PC
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 43902 WOODWARD AVE SUITE116
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48302-5011
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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 | 43902 WOODWARD AVE SUITE116
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48302-5011
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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 | PRESIDENT
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Name | DR. DAVID MICHAEL COWAN
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Credential | PHD
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Telephone | 248-745-0425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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 #3
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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 #4
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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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