Provider Demographics
NPI:1831709559
Name:COWLEY, TEAGUE RICHARD
Entity type:Individual
Prefix:
First Name:TEAGUE
Middle Name:RICHARD
Last Name:COWLEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 SAGEWOOD DR STE H-411
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-7502
Mailing Address - Country:US
Mailing Address - Phone:801-382-8604
Mailing Address - Fax:
Practice Address - Street 1:6300 SAGEWOOD DR STE H-411
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-7502
Practice Address - Country:US
Practice Address - Phone:801-382-8604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor