Provider Demographics
NPI:1609169929
Name:BOWIE, VERA LAVONNE (LISW)
Entity Type:Individual
Prefix:MRS
First Name:VERA
Middle Name:LAVONNE
Last Name:BOWIE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:648 POSSUM HOLLOW TRL
Mailing Address - Street 2:
Mailing Address - City:GERRARDSTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25420-3025
Mailing Address - Country:US
Mailing Address - Phone:703-297-5495
Mailing Address - Fax:
Practice Address - Street 1:AREA A, BUILDING 830, ROOM BHH1-24
Practice Address - Street 2:
Practice Address - City:WPAFB
Practice Address - State:OH
Practice Address - Zip Code:45433
Practice Address - Country:US
Practice Address - Phone:937-257-8058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00080701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical