Provider Demographics
NPI:1235579244
Name:BOWIE, KIMBERLEE A (BS)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLEE
Middle Name:A
Last Name:BOWIE
Suffix:
Gender:F
Credentials:BS
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 3004
Mailing Address - Street 2:
Mailing Address - City:YUMA PROVING GROUND
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-0997
Mailing Address - Country:US
Mailing Address - Phone:520-227-1429
Mailing Address - Fax:
Practice Address - Street 1:1120 CUTTER AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-0997
Practice Address - Country:US
Practice Address - Phone:520-227-1429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-05
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist