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Mark Joseph Mcgowan SR.
Addiction (Substance Use Disorder) Counselor in Indio, California
NPI 1184343063

Mark Joseph Mcgowan SR. is an Addiction (Substance Use Disorder) Counselor based in Indio, CA and is specialized in Addiction (Substance Use Disorder). Mark Joseph Mcgowan SR. practices in Indio, CA. The NPI Number for Mark Joseph Mcgowan SR. is 1184343063 and holds a License No. CI34461221 (California).

The current practice location address for Mark Joseph Mcgowan SR. is 83912 Avenue 45 Ste 9, Indio, CA and can be reached out via phone at 760-347-0754.

Location: 83912 Avenue 45 Ste 9, Indio, CA, 92202-3051
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184343063
Provider Name
Mark Joseph Mcgowan SR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
83912 Avenue 45 Ste 9, Indio, CA, 92202-3051
Phone Number
760-347-0754
Fax Number
Provider Enumeration Date
08/24/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CI34461221 01 CA LICENCE
institution
Provider Business Practice Location Address Details
Address
83912 Avenue 45 Ste 9
City
Indio
State
California
Zip
92201-3338
Phone Number
760-347-0754
Fax Number
person
Provider Business Mailing Address Details
Address
83912 Avenue 45 Ste 9
City
Indio
State
California
Zip
92201-3338
Phone Number
760-347-0754
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
CI34461221 (California)
Definition
Definition to come...
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