Doctor Name: | DR. ABBY BOWEN-RODDA |
NPI Number: | 1013060193 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 218 |
Business Practice Address: | 940 E 3rd St Ste 214 Casper, WY - 826013237 |
Business Phone Number: | 3075774247 |
Business Fax Number: | 3075774249 |
Mailing Address: | 940 E 3rd St, Ste 214 CASPER |
State: | WY |
Postal Code: | 826013237 |
Phone Number: | 3075774247 |
Fax Number: | 3075774249 |
NPI Enumeration Date: | 01/19/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 218 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |