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General NPI Number Information
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NPI Number | 1114358900
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Entity Type | Individual
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Provider Name | KATIE LYNN BOWERS MA, LLP
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Gender | Female
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Dates
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Enumeration Date | 12/05/2013
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 29750 HARPER AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48082-2607
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Country | US
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Telephone | 586-777-3200
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Fax | 586-777-7855
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Provider Business Mailing Address
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Address Line | 79 W ALEXANDRINE ST
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City | DETROIT
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State | MI
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Zip | 48201-2015
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Country | US
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Telephone | 313-831-5535
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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 | 6361003258
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License Number State | MI
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