Provider Demographics
NPI:1326475005
Name:ROWLES, COURTLAND GEORGE
Entity Type:Individual
Prefix:
First Name:COURTLAND
Middle Name:GEORGE
Last Name:ROWLES
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 1:555 31ST ST S
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-1422
Mailing Address - Country:US
Mailing Address - Phone:727-209-2456
Mailing Address - Fax:727-209-0297
Practice Address - Street 1:555 31ST ST S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-1422
Practice Address - Country:US
Practice Address - Phone:727-209-2456
Practice Address - Fax:727-209-0297
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health