Provider Demographics
NPI:1558547596
Name:BOWMAN, ROSEMARY (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 E 6TH ST
Mailing Address - Street 2:2
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-3004
Mailing Address - Country:US
Mailing Address - Phone:617-268-1168
Mailing Address - Fax:
Practice Address - Street 1:564 E 6TH ST
Practice Address - Street 2:2
Practice Address - City:SOUTH BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-3004
Practice Address - Country:US
Practice Address - Phone:617-268-1168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-19
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA106548104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker