Provider Demographics
NPI:1336415389
Name:MOWEN, CARLA GABRIELA (BA)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:GABRIELA
Last Name:MOWEN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7416 SPEEDWELL CAVERN ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-5358
Mailing Address - Country:US
Mailing Address - Phone:808-445-7311
Mailing Address - Fax:
Practice Address - Street 1:3037 E WARM SPRINGS RD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3759
Practice Address - Country:US
Practice Address - Phone:702-780-8447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-23
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst