Provider Demographics
NPI:1134590862
Name:SOWELL, ESTHER
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:SOWELL
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 1:163 HWY 119
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:LA
Mailing Address - Zip Code:71456
Mailing Address - Country:US
Mailing Address - Phone:318-527-3626
Mailing Address - Fax:
Practice Address - Street 1:4000 AIRLINE DR STE 1
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-2042
Practice Address - Country:US
Practice Address - Phone:318-527-3626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251S00000XAgenciesCommunity/Behavioral Health