Provider Demographics
NPI:1689969222
Name:BOWERS, REBECCA A (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:A
Last Name:BOWERS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 FM 156 S
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-4064
Mailing Address - Country:US
Mailing Address - Phone:817-232-1363
Mailing Address - Fax:
Practice Address - Street 1:1395 FM 156 S
Practice Address - Street 2:SUITE 110
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-4064
Practice Address - Country:US
Practice Address - Phone:817-232-1363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-11
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64476101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional