Provider Demographics
NPI:1396188355
Name:BOWYER, MAUREEN LOUISE (MA, LLP)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:LOUISE
Last Name:BOWYER
Suffix:
Gender:F
Credentials:MA, LLP
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:LOUISE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12048 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-9661
Mailing Address - Country:US
Mailing Address - Phone:616-396-2315
Mailing Address - Fax:616-396-0623
Practice Address - Street 1:12048 JAMES ST
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-9661
Practice Address - Country:US
Practice Address - Phone:616-396-2315
Practice Address - Fax:616-396-0623
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014501103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling