Healthcare Provider Details
I. General information
NPI: 1447755988
Provider Name (Legal Business Name): ASHLEY ELIZABETH BOWMAN BCBA/LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/27/2018
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
425 W WASHINGTON ST STE 4
SUFFOLK VA
23434-5320
US
IV. Provider business mailing address
425 W WASHINGTON ST STE 4
SUFFOLK VA
23434-5320
US
V. Phone/Fax
- Phone: 757-774-6111
- Fax:
- Phone: 757-974-0972
- Fax: 757-974-9815
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 0133001994 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: