Provider Demographics
NPI:1558793299
Name:BOWEN, LEAH (LPC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:BOWEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 PARKWOOD BLVD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-1903
Mailing Address - Country:US
Mailing Address - Phone:940-300-1706
Mailing Address - Fax:214-618-5261
Practice Address - Street 1:3550 PARKWOOD BLVD
Practice Address - Street 2:SUITE 401
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-1903
Practice Address - Country:US
Practice Address - Phone:940-300-1706
Practice Address - Fax:214-618-5261
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63498101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional