Provider Demographics
NPI:1508541640
Name:BOWERS, ISABELLA MARIE (LAPC)
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:MARIE
Last Name:BOWERS
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 EMERSON ST SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-2531
Mailing Address - Country:US
Mailing Address - Phone:404-536-7266
Mailing Address - Fax:
Practice Address - Street 1:70 WHITLOCK PL SW STE 100
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-3155
Practice Address - Country:US
Practice Address - Phone:404-494-0201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC008762101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor