Provider Demographics
NPI:1255886644
Name:BOWSER, AYLA (LSW)
Entity type:Individual
Prefix:
First Name:AYLA
Middle Name:
Last Name:BOWSER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5032 DARK SHADE DR
Mailing Address - Street 2:
Mailing Address - City:CAIRNBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:15924-8601
Mailing Address - Country:US
Mailing Address - Phone:814-443-4891
Mailing Address - Fax:814-443-6399
Practice Address - Street 1:1243 SHED RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522-8584
Practice Address - Country:US
Practice Address - Phone:814-623-5166
Practice Address - Fax:814-443-6399
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW133133104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker