Provider Demographics
NPI:1578897922
Name:BOWERY, ASHLEY NICOLE (CASAC INTERN)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:BOWERY
Suffix:
Gender:F
Credentials:CASAC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MERCYCARE LN
Mailing Address - Street 2:
Mailing Address - City:GUILDERLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12084-3504
Mailing Address - Country:US
Mailing Address - Phone:518-452-6700
Mailing Address - Fax:518-452-6756
Practice Address - Street 1:3 MERCYCARE LN
Practice Address - Street 2:
Practice Address - City:GUILDERLAND
Practice Address - State:NY
Practice Address - Zip Code:12084-3504
Practice Address - Country:US
Practice Address - Phone:518-452-6700
Practice Address - Fax:518-452-6756
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility