Provider Demographics
NPI:1821588872
Name:BOWES, GARRETT WILLIAM
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:WILLIAM
Last Name:BOWES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41667 N RABBIT BRUSH TRL
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-4287
Mailing Address - Country:US
Mailing Address - Phone:480-843-8805
Mailing Address - Fax:
Practice Address - Street 1:6232 N 7TH ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-1850
Practice Address - Country:US
Practice Address - Phone:623-693-2954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician