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General NPI Number Information
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NPI Number | 1831113372
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Entity Type | Individual
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Provider Name | PAMELA J. KOWAL M.S. LMFT
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 04/17/2009
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Provider Practice Location Address
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Address Line | 116 E. CHESTNUT ST.
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City | STILLWATER
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State | MN
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Zip | 55082
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Country | US
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Telephone | 651-434-0466
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 574
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City | STILLWATER
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State | MN
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Zip | 55082
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Country | US
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Telephone | 651-434-0466
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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 | 1066
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 616-124
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License Number State | WI
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