| Doctor Name: | MR. KEITH ROBERT MOWERY |
| NPI Number: | 1083046536 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW, CAADC |
| License Number: | 8486 |
| Business Practice Address: | 601 Roxbury Rd Shippensburg, PA - 172579302 |
| Business Phone Number: | 7175302384 |
| Business Fax Number: | 7175302378 |
| Mailing Address: | 601 Roxbury Rd, SHIPPENSBURG |
| State: | PA |
| Postal Code: | 172579302 |
| Phone Number: | 7175302384 |
| Fax Number: | 7175302378 |
| NPI Enumeration Date: | 08/07/2013 |
| NPI Last Update Date: | 01/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 8486 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |