Provider Demographics
NPI:1487098604
Name:COWGER, MISTY DAWN (BA)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:DAWN
Last Name:COWGER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:MISTY
Other - Middle Name:D
Other - Last Name:LAMBRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:1316 SOMERVILLE RD SE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4305
Mailing Address - Country:US
Mailing Address - Phone:256-355-6091
Mailing Address - Fax:256-341-0747
Practice Address - Street 1:4110 HIGHWAY 31 SOUTH
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-1644
Practice Address - Country:US
Practice Address - Phone:256-355-6091
Practice Address - Fax:256-341-0747
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health