Provider Demographics
NPI:1568761609
Name:DOW, ELGIE EUGENE II (LMSW, MSW)
Entity Type:Individual
Prefix:
First Name:ELGIE
Middle Name:EUGENE
Last Name:DOW
Suffix:II
Gender:M
Credentials:LMSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 MCCANN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT IGNACE
Mailing Address - State:MI
Mailing Address - Zip Code:49781-1651
Mailing Address - Country:US
Mailing Address - Phone:906-643-7487
Mailing Address - Fax:906-643-7487
Practice Address - Street 1:298 MCCANN ST
Practice Address - Street 2:
Practice Address - City:SAINT IGNACE
Practice Address - State:MI
Practice Address - Zip Code:49781-1651
Practice Address - Country:US
Practice Address - Phone:906-643-7487
Practice Address - Fax:906-643-7487
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI680100584101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health