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General NPI Number Information
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NPI Number | 1083745814
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Entity Type | Individual
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Provider Name | SHIRLEY ANNE BOWLES ED.D.
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 130 N TRADD ST SUITE D
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City | STATESVILLE
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State | NC
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Zip | 28677-5240
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Country | US
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Telephone | 704-881-0129
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Fax | 704-838-1140
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Provider Business Mailing Address
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Address Line | 813 VALLEY ST
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City | STATESVILLE
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State | NC
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Zip | 28677-3542
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Country | US
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Telephone | 704-754-6383
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3054
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License Number State | NC
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