Provider Demographics
NPI:1760788822
Name:BOWLES, MARY ELIZABETH (MA, MFT)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:BOWLES
Suffix:
Gender:F
Credentials:MA, MFT
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 556
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:CO
Mailing Address - Zip Code:81647
Mailing Address - Country:US
Mailing Address - Phone:970-230-0225
Mailing Address - Fax:970-945-5523
Practice Address - Street 1:386 W. MAIN ST.
Practice Address - Street 2:SUITE #302
Practice Address - City:NEW CASTLE
Practice Address - State:CO
Practice Address - Zip Code:81647
Practice Address - Country:US
Practice Address - Phone:970-230-0225
Practice Address - Fax:970-625-9707
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0103256106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist