Provider Demographics
NPI:1619583325
Name:BOWE, VALARIE
Entity Type:Individual
Prefix:MS
First Name:VALARIE
Middle Name:
Last Name:BOWE
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 1:61 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:ERIAL
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-2106
Mailing Address - Country:US
Mailing Address - Phone:856-220-6794
Mailing Address - Fax:
Practice Address - Street 1:116 WHITE HORSE PIKE FL 2NDR
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1928
Practice Address - Country:US
Practice Address - Phone:856-428-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00840900225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist