Provider Demographics
NPI:1518561430
Name:BOWMAN, BETH ANNE
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANNE
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 E MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-4802
Mailing Address - Country:US
Mailing Address - Phone:334-521-8302
Mailing Address - Fax:
Practice Address - Street 1:328 E MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-4802
Practice Address - Country:US
Practice Address - Phone:334-521-8302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC3610A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health