Healthcare Provider Details
I. General information
NPI: 1427714385
Provider Name (Legal Business Name): AMY FRANCES BOWMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/15/2021
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5001 W ALBAIN RD
MONROE MI
48161-9558
US
IV. Provider business mailing address
8765 LEWIS AVE
TEMPERANCE MI
48182-9583
US
V. Phone/Fax
- Phone: 734-847-3802
- Fax:
- Phone: 734-847-3802
- Fax: 734-850-0520
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 6451022007 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: