Healthcare Provider Details

I. General information

NPI: 1043810187
Provider Name (Legal Business Name): AMBER N BOWERS CBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2020
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 COMMERCE ST STE 204
TACOMA WA
98402-4514
US

IV. Provider business mailing address

515 LOST TRL UNIT A
COPPERAS COVE TX
76522-7243
US

V. Phone/Fax

Practice location:
  • Phone: 253-649-9749
  • Fax:
Mailing address:
  • Phone: 915-630-1589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: