Healthcare Provider Details

I. General information

NPI: 1023059896
Provider Name (Legal Business Name): JUDITH BOWIE ROWAN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 FRANKLIN ST
EXETER NH
03833-2819
US

IV. Provider business mailing address

4 FRANKLIN ST
EXETER NH
03833-2819
US

V. Phone/Fax

Practice location:
  • Phone: 603-773-0190
  • Fax:
Mailing address:
  • Phone: 603-773-0190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number336
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: