Provider Demographics
NPI:1023859782
Name:BOWERS, RAILYN KYSE
Entity type:Individual
Prefix:
First Name:RAILYN
Middle Name:KYSE
Last Name:BOWERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1723 BOWERS RD
Mailing Address - Street 2:
Mailing Address - City:WESTVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32464-3178
Mailing Address - Country:US
Mailing Address - Phone:850-557-1651
Mailing Address - Fax:
Practice Address - Street 1:211 W IOWA AVE
Practice Address - Street 2:
Practice Address - City:BONIFAY
Practice Address - State:FL
Practice Address - Zip Code:32425-2103
Practice Address - Country:US
Practice Address - Phone:850-726-8242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst