Provider Demographics
NPI:1841615119
Name:NOWLIN, MARIA (LPC, MT-BC, NCC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:NOWLIN
Suffix:
Gender:F
Credentials:LPC, MT-BC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 CAMERON BLVD
Mailing Address - Street 2:
Mailing Address - City:KEMP
Mailing Address - State:TX
Mailing Address - Zip Code:75143-5647
Mailing Address - Country:US
Mailing Address - Phone:214-326-0604
Mailing Address - Fax:
Practice Address - Street 1:3402 OAK GROVE AVE
Practice Address - Street 2:305
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2353
Practice Address - Country:US
Practice Address - Phone:214-326-0604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69001101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional