Doctor Name: | THERESA BOWES |
NPI Number: | 1386687226 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 39000115A |
Business Practice Address: | 8320 Madison Ave Indpls, IN - 46227 |
Business Phone Number: | 3178825122 |
Business Fax Number: | 3178888642 |
Mailing Address: | 819 E. 64th Street, D3, INDIANAPOLIS |
State: | IN |
Postal Code: | 46220 |
Phone Number: | 3174750023 |
Fax Number: | 3175683761 |
NPI Enumeration Date: | 06/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 39000115A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |