Provider Demographics
NPI:1659888030
Name:BOWDEN, MULVENIA
Entity Type:Individual
Prefix:
First Name:MULVENIA
Middle Name:
Last Name:BOWDEN
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 1:610 LARCHMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-2839
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7412 GEORGIA AVE NW STE 4
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1754
Practice Address - Country:US
Practice Address - Phone:202-531-7039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-06
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG500820531041C0700X
DCLC2000022491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical