Provider Demographics
NPI:1285915553
Name:DOWELL, KATHY (PHD LP)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:DOWELL
Suffix:
Gender:F
Credentials:PHD LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 ORDEAN CT
Mailing Address - Street 2:326 BOHANNON HALL
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55812-3010
Mailing Address - Country:US
Mailing Address - Phone:218-726-6742
Mailing Address - Fax:
Practice Address - Street 1:301 W 1ST ST
Practice Address - Street 2:SUITE 503
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1613
Practice Address - Country:US
Practice Address - Phone:218-491-0746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4951103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical