Provider Demographics
NPI:1033866702
Name:BOWEN, NICOLE JEANNE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:JEANNE
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 SOUTH ST # 4007
Mailing Address - Street 2:
Mailing Address - City:SOUTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01550-4032
Mailing Address - Country:US
Mailing Address - Phone:508-909-7260
Mailing Address - Fax:
Practice Address - Street 1:139 SOUTH ST
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-4032
Practice Address - Country:US
Practice Address - Phone:508-909-7260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker