Doctor Name: | GAYLE B BOWMAN |
NPI Number: | 1699822478 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 4235 |
Business Practice Address: | 2480 Llewellyn Ave Fort George G Meade, MD - 207555800 |
Business Phone Number: | 3016778270 |
Business Fax Number: | |
Mailing Address: | 2480 Llewellyn Ave, FORT GEORGE G MEADE |
State: | MD |
Postal Code: | 207555800 |
Phone Number: | 3016778270 |
Fax Number: | |
NPI Enumeration Date: | 01/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4235 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |