| Organization Name: | BOWMAN-LYDY COUNSELING,LLC |
| NPI Number: | 1114321999 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GWENDOLYN ANNE LYDY (LICENSED PROFESSIONAL COUNSELOR) |
| Mailing Address: | 1259 State Route 203 Delaware |
| State: | OH US |
| Postal Code: | 430159759 |
| Phone Number: | 7408157523 |
| Fax Number: | |
| NPI Enumeration Date: | 10/22/2014 |
| NPI Last Update Date: | 10/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | C.0700124 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |