Provider Demographics
NPI:1093541302
Name:BOWLIN, LAURA ANNE (LMFTA)
Entity type:Individual
Prefix:
First Name:LAURA ANNE
Middle Name:
Last Name:BOWLIN
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8202 SE 30TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-3011
Mailing Address - Country:US
Mailing Address - Phone:425-283-3118
Mailing Address - Fax:
Practice Address - Street 1:8202 SE 30TH ST
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-3011
Practice Address - Country:US
Practice Address - Phone:425-283-3118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG61549045103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling