Provider Demographics
NPI: | 1033609029 |
---|---|
Name: | MELANIE BOWMAN THERAPY LLC |
Entity Type: | Organization |
Organization Name: | MELANIE BOWMAN THERAPY LLC |
Other - Org Name: | CAREGIVER STRATEGIES AND SUPPORT, LLC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | FOUNDER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MELANIE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BOWMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 813-748-7213 |
Mailing Address - Street 1: | 1135 11TH ST N |
Mailing Address - Street 2: | |
Mailing Address - City: | SAINT PETERSBURG |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33705-1117 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 813-748-7213 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1135 11TH ST N |
Practice Address - Street 2: | |
Practice Address - City: | SAINT PETERSBURG |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33705-1117 |
Practice Address - Country: | US |
Practice Address - Phone: | 813-748-7213 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-05-15 |
Last Update Date: | 2019-06-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | SW10153 | 251S00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health |