Provider Demographics
NPI:1235997677
Name:ROWELLS, DAMON
Entity Type:Individual
Prefix:
First Name:DAMON
Middle Name:
Last Name:ROWELLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15999 SW 54TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5617
Mailing Address - Country:US
Mailing Address - Phone:786-260-5568
Mailing Address - Fax:
Practice Address - Street 1:701 PROMENADE DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-6034
Practice Address - Country:US
Practice Address - Phone:650-213-2283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst