Provider Demographics
NPI:1447574041
Name:BOWEN, DUNCAN N JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:DUNCAN
Middle Name:N
Last Name:BOWEN
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 S PATRICK DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3963
Mailing Address - Country:US
Mailing Address - Phone:321-779-9838
Mailing Address - Fax:321-779-4502
Practice Address - Street 1:1275 S PATRICK DR
Practice Address - Street 2:SUITE C
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3963
Practice Address - Country:US
Practice Address - Phone:321-779-9838
Practice Address - Fax:321-779-4502
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 645101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional