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General NPI Number Information
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NPI Number | 1962826974
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Entity Type | Individual
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Provider Name | WESLEY MARSHALL BOWMAN MSED, LPC
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Gender | Male
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Dates
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Enumeration Date | 02/11/2014
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Last Update Date | 06/27/2016
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Provider Practice Location Address
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Address Line | 1182 GRAVES AVE UNIT C SUITE #2
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City | ESTES PARK
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State | CO
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Zip | 80517-7742
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Country | US
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Telephone | 970-238-0268
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Fax | 970-692-2594
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Provider Business Mailing Address
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Address Line | 1182 GRAVES AVE UNIT C SUITE #2
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City | ESTES PARK
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State | CO
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Zip | 80517-7742
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Country | US
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Telephone | 970-238-0268
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Fax | 970-692-2594
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC.0012110
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License Number State | CO
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