Provider Demographics
NPI:1851658058
Name:ANDERSON KOWAL, TOBBY T (SLPA)
Entity type:Individual
Prefix:MRS
First Name:TOBBY
Middle Name:T
Last Name:ANDERSON KOWAL
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:MRS
Other - First Name:TOBBY
Other - Middle Name:T
Other - Last Name:ANDERSON KOWAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFTA
Mailing Address - Street 1:9330 59TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2858
Mailing Address - Country:US
Mailing Address - Phone:480-374-0883
Mailing Address - Fax:
Practice Address - Street 1:9330 59TH AVE SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2858
Practice Address - Country:US
Practice Address - Phone:253-581-7020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG61580737106H00000X
AZSLPA77012355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant