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General NPI Number Information
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NPI Number | 1144878505
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Entity Type | Individual
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Provider Name | ARCHELLE BOWEN
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Gender | Female
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Dates
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Enumeration Date | 08/29/2019
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Last Update Date | 08/29/2019
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Provider Practice Location Address
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Address Line | 3261 OLD WASHINGTON RD STE 1040
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City | WALDORF
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State | MD
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Zip | 20602-3244
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Country | US
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Telephone | 301-259-5782
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Fax |
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Provider Business Mailing Address
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Address Line | 6782 MCCORMICK DR
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City | BRYANS ROAD
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State | MD
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Zip | 20616-4272
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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