Provider Demographics
NPI:1801085048
Name:COWSER, TRISTICIA VENIECE (MS)
Entity type:Individual
Prefix:MRS
First Name:TRISTICIA
Middle Name:VENIECE
Last Name:COWSER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:TRISTICIA
Other - Middle Name:VENIECE
Other - Last Name:LOCKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:901 GOODYEAR AVE
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1106
Mailing Address - Country:US
Mailing Address - Phone:256-492-7800
Mailing Address - Fax:
Practice Address - Street 1:901 GOODYEAR AVE
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1106
Practice Address - Country:US
Practice Address - Phone:256-492-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health