Provider Demographics
NPI:1164749271
Name:BOWIE, MOLLY ANN (BS)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:ANN
Last Name:BOWIE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MS
Other - First Name:MOLLY
Other - Middle Name:ANN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1406 HAYS ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2833
Mailing Address - Country:US
Mailing Address - Phone:850-521-0242
Mailing Address - Fax:
Practice Address - Street 1:406 TOURNAMENT RD
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-3647
Practice Address - Country:US
Practice Address - Phone:904-534-6935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst