Provider Demographics
NPI:1114425139
Name:BOWIE, ANGELA M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:M
Last Name:BOWIE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:892 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-2261
Mailing Address - Country:US
Mailing Address - Phone:405-249-1614
Mailing Address - Fax:
Practice Address - Street 1:4347 W GAY RD
Practice Address - Street 2:
Practice Address - City:DIBERVILLE
Practice Address - State:MS
Practice Address - Zip Code:39540-3412
Practice Address - Country:US
Practice Address - Phone:228-392-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC82951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical