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General NPI Number Information
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NPI Number | 1346352044
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Entity Type | Individual
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Provider Name | MICHELE K BOWEN LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 03/19/2014
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Provider Practice Location Address
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Address Line | 115 S ST. JOSEPH AVE
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City | NILES
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State | MI
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Zip | 49120
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Country | US
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Telephone | 269-684-4270
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Fax | 269-684-4070
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Provider Business Mailing Address
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Address Line | 1485 S M-139
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City | BENTON HARBOR
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State | MI
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Zip | 49022
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Country | US
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Telephone | 269-925-0585
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Fax | 269-927-1326
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801085883
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License Number State | MI
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