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General NPI Number Information
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NPI Number | 1831532993
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Entity Type | Individual
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Provider Name | SUZANNE BOWMAN LICSW
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Gender | Female
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Dates
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Enumeration Date | 04/09/2013
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 18 IMPERIAL PL UNIT 5B
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City | PROVIDENCE
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State | RI
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Zip | 02903-4641
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Country | US
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Telephone | 401-751-6080
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Fax | 401-751-6080
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Provider Business Mailing Address
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Address Line | 18 IMPERIAL PL UNIT 5B
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City | PROVIDENCE
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State | RI
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Zip | 02903-4643
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Country | US
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Telephone | 401-751-6080
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Fax | 401-751-6080
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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 | ISW00204
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 106910
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License Number State | MA
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