| Doctor Name: | DR. KATIE LARYN COWAN |
| NPI Number: | 1326230533 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 003177 |
| Business Practice Address: | 953 Harmony Rd Suite 104 Eatonton, GA - 310246296 |
| Business Phone Number: | 4049316555 |
| Business Fax Number: | 4043939635 |
| Mailing Address: | 1300 Granite Cove Dr, GREENSBORO |
| State: | GA |
| Postal Code: | 306427000 |
| Phone Number: | 4049316555 |
| Fax Number: | 4043939635 |
| NPI Enumeration Date: | 08/11/2007 |
| NPI Last Update Date: | 09/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 003177 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |