=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841903382
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LEAH BOWDEN PSY.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/29/2022
-----------------------------------------------------
Last Update Date | 04/21/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20 E TAUNTON RD STE 540
-----------------------------------------------------
City | BERLIN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08009-2625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-809-2940
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20 E TAUNTON RD STE 540
-----------------------------------------------------
City | BERLIN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08009-2625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-341-3981
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------