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General NPI Number Information
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NPI Number | 1477810802
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Entity Type | Organization
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Legal Business Name | THE BOWEN WELLNESS CENTER
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 07/25/2012
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Provider Practice Location Address
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Address Line | 10515 W MARKHAM ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-2297
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Country | US
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Telephone | 501-823-0627
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Fax |
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Provider Business Mailing Address
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Address Line | 10515 W MARKHAM ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-2297
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Country | US
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Telephone | 501-823-0627
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | ANGELA BOWEN
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Credential | LAC
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Telephone | 501-823-0627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A1106058
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License Number State | AR
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