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General NPI Number Information
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NPI Number | 1578705893
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Entity Type | Individual
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Provider Name | SYLVIA BOWEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 09/14/2017
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Provider Practice Location Address
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Address Line | 317 BUNKER AVE
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City | AZTEC
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State | NM
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Zip | 87410-2307
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Country | US
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Telephone | 208-260-2821
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Fax |
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Provider Business Mailing Address
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Address Line | 2979 COUNTY ROAD 222
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City | DURANGO
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State | CO
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Zip | 81303-8166
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Country | US
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Telephone | 970-889-7116
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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 | I-08798
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License Number State | NM
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