Provider Demographics
NPI:1962828442
Name:MCGOWIN, FELICIA LEIGH
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:LEIGH
Last Name:MCGOWIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 W TRUDGEON ST
Mailing Address - Street 2:
Mailing Address - City:HENRYETTA
Mailing Address - State:OK
Mailing Address - Zip Code:74437-4027
Mailing Address - Country:US
Mailing Address - Phone:918-650-9500
Mailing Address - Fax:918-650-9559
Practice Address - Street 1:403 W TRUDGEON ST
Practice Address - Street 2:
Practice Address - City:HENRYETTA
Practice Address - State:OK
Practice Address - Zip Code:74437-4027
Practice Address - Country:US
Practice Address - Phone:918-650-9500
Practice Address - Fax:918-650-9559
Is Sole Proprietor?:No
Enumeration Date:2014-03-08
Last Update Date:2014-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst