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General NPI Number Information
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NPI Number | 1285837062
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Entity Type | Individual
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Provider Name | ERNESTINE JOYCE BOWREN LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3234 N 36TH ST
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City | KANSAS CITY
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State | KS
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Zip | 66104-3714
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Country | US
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Telephone | 913-371-0477
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Fax |
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Provider Business Mailing Address
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Address Line | 3234 N 36TH ST
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City | KANSAS CITY
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State | KS
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Zip | 66104-3714
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Country | US
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Telephone | 913-371-0477
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 001043
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License Number State | MO
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