Provider Demographics
NPI:1831113372
Name:KOWAL, PAMELA J (MS LMFT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:J
Last Name:KOWAL
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:J
Other - Last Name:HENKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 574
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082
Mailing Address - Country:US
Mailing Address - Phone:651-434-0466
Mailing Address - Fax:
Practice Address - Street 1:116 E. CHESTNUT ST.
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082
Practice Address - Country:US
Practice Address - Phone:651-434-0466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1066101YM0800X
WI616-124101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health