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General NPI Number Information
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NPI Number | 1649865247
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Entity Type | Individual
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Provider Name | KELSEY CHRISTINE BOWEN
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Gender | Female
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 2301 LAGUNA CIR APT 204
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City | NORTH MIAMI
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State | FL
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Zip | 33181-1090
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Country | US
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Telephone | 305-469-0422
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Fax |
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Provider Business Mailing Address
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Address Line | 4531 NW 197TH ST
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City | MIAMI GARDENS
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State | FL
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Zip | 33055-1827
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Country | US
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Telephone |
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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 | SW17934
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License Number State | FL
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