Provider Demographics
NPI:1609084003
Name:COWAN, EMORY GARLAND JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:EMORY
Middle Name:GARLAND
Last Name:COWAN
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5317 CRACKER BARREL CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-1803
Mailing Address - Country:US
Mailing Address - Phone:719-570-7844
Mailing Address - Fax:
Practice Address - Street 1:555 E PIKES PEAK AVE
Practice Address - Street 2:#108
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3641
Practice Address - Country:US
Practice Address - Phone:719-442-0505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLMFT #034106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist