Provider Demographics
NPI:1346969938
Name:BOWLEY, BRIANNA (BS, CDCA)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:BOWLEY
Suffix:
Gender:F
Credentials:BS, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 ESTESS AVE
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-1617
Mailing Address - Country:US
Mailing Address - Phone:419-360-2376
Mailing Address - Fax:
Practice Address - Street 1:1946 N 13TH ST STE 472
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-7257
Practice Address - Country:US
Practice Address - Phone:419-967-7892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH181315101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)