Provider Demographics
NPI:1407307945
Name:ROWE, PANYA JAMILA (MA LPC)
Entity Type:Individual
Prefix:
First Name:PANYA
Middle Name:JAMILA
Last Name:ROWE
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 PECAN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-4070
Mailing Address - Country:US
Mailing Address - Phone:214-991-5550
Mailing Address - Fax:
Practice Address - Street 1:8035 E RL THRTN FWY
Practice Address - Street 2:SUITE NUMBER 328
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-7018
Practice Address - Country:US
Practice Address - Phone:469-901-0696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73671101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional