Provider Demographics
NPI:1629789953
Name:BOWDEN-LITTLE, JOHN PATRICK (MPH, MA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PATRICK
Last Name:BOWDEN-LITTLE
Suffix:
Gender:M
Credentials:MPH, MA
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:PATRICK
Other - Last Name:LITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4205 COLLEGIATE WAY APT 131
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-7201
Mailing Address - Country:US
Mailing Address - Phone:989-860-9052
Mailing Address - Fax:
Practice Address - Street 1:2800 S SHEPHERD RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-8966
Practice Address - Country:US
Practice Address - Phone:989-775-4850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health