Provider Demographics
NPI:1346985298
Name:BOWEN, MARIA ROSE (MA, LCMHC, R-DMT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ROSE
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MA, LCMHC, R-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WOODS RD
Mailing Address - Street 2:
Mailing Address - City:E DUMMERSTON
Mailing Address - State:VT
Mailing Address - Zip Code:05346-9793
Mailing Address - Country:US
Mailing Address - Phone:617-780-1951
Mailing Address - Fax:
Practice Address - Street 1:8 WOODS RD
Practice Address - Street 2:
Practice Address - City:E DUMMERSTON
Practice Address - State:VT
Practice Address - Zip Code:05346-9793
Practice Address - Country:US
Practice Address - Phone:617-780-1951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0134562101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health