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NPI Code Detail

MEDICARE: DIANE APRIL BOWLUS OT/L

MEDICARE:   DIANE APRIL BOWLUS  OT/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist1785AZ
2225XH1300XHuman Factors Occupational Therapist1785AZ
3225XP0200XPediatric Occupational Therapist1785AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1556003OTHERAZAHCCCS

General Provider Information

NPI Number : 1922008515
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE APRIL BOWLUS OT/L
Provider Business Mailing Address
First Line : PO BOX 640
Second Line :
City : CAMP VERDE
State : AZ
Zip : 86322-0640
Country : US
Telephone Number : 928-567-7330
Fax Number : 928-567-4146
Provider Business Practice Location Address
First Line : 513 AZURE DR
Second Line :
City : CAMP VERDE
State : AZ
Zip : 86322-7276
Country : US
Telephone Number : 928-567-7330
Fax Number : 928-567-4146
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 09/11/2025

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Directions to “ DIANE APRIL BOWLUS OT/L” Practice Location

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