Provider Demographics
NPI:1942630900
Name:COWAN, JANICE LYNN (BCBA-L)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:LYNN
Last Name:COWAN
Suffix:
Gender:F
Credentials:BCBA-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10516 EDGEWATER RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3762
Mailing Address - Country:US
Mailing Address - Phone:618-201-2882
Mailing Address - Fax:
Practice Address - Street 1:10516 EDGEWATER RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-3762
Practice Address - Country:US
Practice Address - Phone:618-201-2882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0065103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst