Provider Demographics
NPI:1881920791
Name:SOWARD, JOSHUA KEITH I (MA)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:KEITH
Last Name:SOWARD
Suffix:I
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 E DELMAR ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-1532
Mailing Address - Country:US
Mailing Address - Phone:606-301-1164
Mailing Address - Fax:
Practice Address - Street 1:1130 E DELMAR ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-1532
Practice Address - Country:US
Practice Address - Phone:606-301-1164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20090322720101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional