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General NPI Number Information
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NPI Number | 1518467612
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Entity Type | Individual
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Provider Name | RACHAEL FAITH BOWDEN LMT
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Gender | Female
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Dates
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Enumeration Date | 02/15/2018
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Last Update Date | 02/15/2018
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Provider Practice Location Address
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Address Line | 3933 HWY 59 SUITE A
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City | MANDEVILLE
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State | LA
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Zip | 70471-1958
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Country | US
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Telephone | 985-629-1332
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Fax | 985-327-5449
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Provider Business Mailing Address
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Address Line | 3933 HIGHWAY 59 STE A
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City | MANDEVILLE
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State | LA
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Zip | 70471-1958
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Country | US
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Telephone | 985-629-1332
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Fax | 985-327-5449
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 8162
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License Number State | LA
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