Organization Name: | ABBY BOWEN-RODDA PH.D., PC |
NPI Number: | 1023289485 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ABBY BOWEN-RODDA (OWNER) |
Mailing Address: | 940 E 3rd St Ste 107 Casper |
State: | WY US |
Postal Code: | 826013237 |
Phone Number: | 3075774247 |
Fax Number: | 3075774249 |
NPI Enumeration Date: | 03/13/2008 |
NPI Last Update Date: | 03/13/2008 |
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: |