Provider Demographics
NPI:1891545703
Name:MOWRY, PAUL HENRY (PHD STUDENT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:HENRY
Last Name:MOWRY
Suffix:
Gender:M
Credentials:PHD STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4858 SNICKERS DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38002-8707
Mailing Address - Country:US
Mailing Address - Phone:901-569-4347
Mailing Address - Fax:
Practice Address - Street 1:4858 SNICKERS DR
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38002-8707
Practice Address - Country:US
Practice Address - Phone:901-569-4347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling