Provider Demographics
NPI:1407173560
Name:BOWMAN, DANIELLE (LPC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 BROADWAY ST
Mailing Address - Street 2:#1033
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7811
Mailing Address - Country:US
Mailing Address - Phone:832-433-1946
Mailing Address - Fax:855-577-8978
Practice Address - Street 1:1401 RICHMOND AVE STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5482
Practice Address - Country:US
Practice Address - Phone:281-721-9939
Practice Address - Fax:866-306-2987
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74613101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX354902401Medicaid