Provider Demographics
NPI:1508820580
Name:BOWMAN, HELEN L (M ED)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:L
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 E PARK AVE
Mailing Address - Street 2:STE 7
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-2271
Mailing Address - Country:US
Mailing Address - Phone:814-371-1340
Mailing Address - Fax:814-371-1864
Practice Address - Street 1:25 E PARK AVE
Practice Address - Street 2:STE 7
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2271
Practice Address - Country:US
Practice Address - Phone:814-371-1340
Practice Address - Fax:814-371-1864
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-007769-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016838240003Medicaid