Provider Demographics
NPI:1679130967
Name:ROWL, KIRBY (CADC)
Entity type:Individual
Prefix:
First Name:KIRBY
Middle Name:
Last Name:ROWL
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:KIRBY
Other - Middle Name:
Other - Last Name:COPELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501
Mailing Address - Country:US
Mailing Address - Phone:641-683-6747
Mailing Address - Fax:641-683-6317
Practice Address - Street 1:310 W. MAIN ST
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501
Practice Address - Country:US
Practice Address - Phone:641-683-6747
Practice Address - Fax:641-683-6317
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1059291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical