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General NPI Number Information
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NPI Number | 1649099581
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Entity Type | Individual
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Provider Name | JENNIFER LAUREN BOWENS
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Gender | Female
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 20 VANDERHOOF AVE
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City | ROCKAWAY
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State | NJ
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Zip | 07866-3148
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Country | US
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Telephone | 484-634-0319
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Fax |
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Provider Business Mailing Address
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Address Line | 3517 HIGH HILL RD
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City | EFFORT
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State | PA
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Zip | 18330-7712
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Country | US
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Telephone | 484-634-0319
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL06741110
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License Number State | NJ
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