| Doctor Name: | BREANA S BOWSHER |
| NPI Number: | 1003079005 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | |
| Business Practice Address: | 415 E Madison St South Bend, IN - 466172322 |
| Business Phone Number: | 5742831234 |
| Business Fax Number: | 5742831361 |
| Mailing Address: | Po Box 809, GOSHEN |
| State: | IN |
| Postal Code: | 465270809 |
| Phone Number: | 5745331234 |
| Fax Number: | 5745372652 |
| NPI Enumeration Date: | 07/09/2008 |
| NPI Last Update Date: | 03/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |