Provider Demographics
NPI:1134116122
Name:BOWLER, DEBORAH LEANN (CHT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LEANN
Last Name:BOWLER
Suffix:
Gender:F
Credentials:CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 791217
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-1217
Mailing Address - Country:US
Mailing Address - Phone:301-932-4785
Mailing Address - Fax:301-932-4789
Practice Address - Street 1:22715 WASHINGTON STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-0309
Practice Address - Country:US
Practice Address - Phone:301-997-0172
Practice Address - Fax:301-997-0175
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04861225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist