Healthcare Provider Details

I. General information

NPI: 1841741121
Provider Name (Legal Business Name): MARY A. BOWERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 N CEDAR ST
FLORENCE AL
35630-5406
US

IV. Provider business mailing address

444 N CEDAR ST
FLORENCE AL
35630-5406
US

V. Phone/Fax

Practice location:
  • Phone: 256-767-6139
  • Fax: 256-767-3408
Mailing address:
  • Phone: 256-767-6139
  • Fax: 256-767-3408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number821
License Number StateAL

VIII. Authorized Official

Name: DR. MARY ANN BOWERS
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 256-366-3889