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NPI Code Detail

MEDICARE: KATRINA LYNN BOWERS CDCA

MEDICARE: KATRINA LYNN BOWERS CDCA
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.178192OH
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1992303697
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATRINA LYNN BOWERS CDCA
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3950 SUNFOREST CT FL 2
Second Line :
City : TOLEDO
State : OH
Zip : 43623-4485
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2020
Last Update Date : 03/12/2025

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