Provider Demographics
NPI:1376979336
Name:BOWEN, TALEISHA Q (MS, EDS)
Entity Type:Individual
Prefix:
First Name:TALEISHA
Middle Name:Q
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MS, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 OAK BRANCH DR STE C
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-2392
Mailing Address - Country:US
Mailing Address - Phone:336-856-1140
Mailing Address - Fax:336-856-1128
Practice Address - Street 1:7 OAK BRANCH DR STE C
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407
Practice Address - Country:US
Practice Address - Phone:336-856-1140
Practice Address - Fax:336-856-1140
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health