| Doctor Name: | BRIAN COWART |
| NPI Number: | 1093118168 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.C.P. |
| License Number: | 0810005076 |
| Business Practice Address: | 700 University City Blvd Blacksburg, VA - 240602706 |
| Business Phone Number: | 5409618300 |
| Business Fax Number: | 5409618465 |
| Mailing Address: | 700 University City Blvd, BLACKSBURG |
| State: | VA |
| Postal Code: | 240602706 |
| Phone Number: | 5409618300 |
| Fax Number: | 5409618465 |
| NPI Enumeration Date: | 10/03/2014 |
| NPI Last Update Date: | 10/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 0810005076 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |