Provider Demographics
NPI:1629723242
Name:KOWNSLAR, KEITH
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:KOWNSLAR
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 1:6609 ROBBIE CREEK CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-8139
Mailing Address - Country:US
Mailing Address - Phone:512-790-8722
Mailing Address - Fax:
Practice Address - Street 1:6609 ROBBIE CREEK CV
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-8139
Practice Address - Country:US
Practice Address - Phone:512-790-8722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87466101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional