Provider Demographics
NPI:1326265380
Name:HELEN BOWMAN, PSY
Entity Type:Organization
Organization Name:HELEN BOWMAN, PSY
Other - Org Name:BREEZEWOOD BEHAVIORAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIGILARMO
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:814-371-1340
Mailing Address - Street 1:90 BEAVER DR
Mailing Address - Street 2:STE 117D
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-2440
Mailing Address - Country:US
Mailing Address - Phone:814-371-1340
Mailing Address - Fax:814-371-1864
Practice Address - Street 1:90 BEAVER DR
Practice Address - Street 2:STE 117D
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2440
Practice Address - Country:US
Practice Address - Phone:814-371-1340
Practice Address - Fax:814-371-1864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-007769-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016812320001Medicaid
PA1016812320002Medicaid