Provider Demographics
NPI:1508730300
Name:COWELL, TONY
Entity type:Individual
Prefix:
First Name:TONY
Middle Name:
Last Name:COWELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6710 OXON HILL RD STE 210
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-1124
Mailing Address - Country:US
Mailing Address - Phone:240-659-8583
Mailing Address - Fax:
Practice Address - Street 1:6710 OXON HILL RD STE 210
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-1124
Practice Address - Country:US
Practice Address - Phone:240-659-8583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician