Provider Demographics
NPI:1033526066
Name:SOWELL, ROBERT (MS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:SOWELL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 S. ZACK HINTON PARKWAY
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-7441
Mailing Address - Country:US
Mailing Address - Phone:678-432-3330
Mailing Address - Fax:678-432-3662
Practice Address - Street 1:125 S. ZACK HINTON PARKWAY
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-7441
Practice Address - Country:US
Practice Address - Phone:678-432-3330
Practice Address - Fax:678-432-3662
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-22
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)