Provider Demographics
NPI:1497438634
Name:MCDOWELL, LOUISE MARIE (RBT)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:MARIE
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 TREY LN
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-5204
Mailing Address - Country:US
Mailing Address - Phone:404-399-3361
Mailing Address - Fax:
Practice Address - Street 1:1645 TREY LN
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-5204
Practice Address - Country:US
Practice Address - Phone:404-399-3361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA22-247882106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician