Provider Demographics
NPI:1861825358
Name:COWLEY, EMILY KATHERINE (DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KATHERINE
Last Name:COWLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 WINTERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-7646
Mailing Address - Country:US
Mailing Address - Phone:985-859-4265
Mailing Address - Fax:
Practice Address - Street 1:8610B FERN AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5639
Practice Address - Country:US
Practice Address - Phone:318-220-8753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08638225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1174173Medicaid
LA1174173Medicaid