Healthcare Provider Details

I. General information

NPI: 1861208910
Provider Name (Legal Business Name): MRS. ELIZABETH BOWERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6130 N CAPITOL ST NW
WASHINGTON DC
20011-1405
US

IV. Provider business mailing address

3430 DENTAL CT
EDGEWATER MD
21037-2683
US

V. Phone/Fax

Practice location:
  • Phone: 202-729-6660
  • Fax:
Mailing address:
  • Phone: 339-707-0534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225CX0006X
TaxonomyOrientation and Mobility Training Rehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: