Provider Demographics
NPI:1720188287
Name:BOWMAN, MARSHA L (LPCC CLINICAL MENTAL)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:L
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LPCC CLINICAL MENTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 620
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88062-0620
Mailing Address - Country:US
Mailing Address - Phone:575-574-8889
Mailing Address - Fax:575-388-9151
Practice Address - Street 1:4567 TIMMER WAY WEST
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061
Practice Address - Country:US
Practice Address - Phone:575-574-8889
Practice Address - Fax:575-388-9151
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM005668101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional