Provider Demographics
NPI:1710358551
Name:BOWSER, MALIKA (QP,MSW,LCSW-A,LCAS-A)
Entity Type:Individual
Prefix:
First Name:MALIKA
Middle Name:
Last Name:BOWSER
Suffix:
Gender:F
Credentials:QP,MSW,LCSW-A,LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 HAY ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5313
Mailing Address - Country:US
Mailing Address - Phone:910-438-0939
Mailing Address - Fax:910-438-0942
Practice Address - Street 1:911 HAY ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5313
Practice Address - Country:US
Practice Address - Phone:910-438-0939
Practice Address - Fax:910-438-0942
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0099821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical