Provider Demographics
NPI:1114137445
Name:BOWERS, LAURA BROOKE (MA, NCC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BROOKE
Last Name:BOWERS
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 GRANADA DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-5109
Mailing Address - Country:US
Mailing Address - Phone:919-782-7424
Mailing Address - Fax:
Practice Address - Street 1:1000 CORPORATE DR STE 401
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-8548
Practice Address - Country:US
Practice Address - Phone:919-643-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health