Provider Demographics
NPI:1265062350
Name:DOGWOOD PSYCHOLOGY CENTER FOR CHILDREN AND FAMILIES
Entity type:Organization
Organization Name:DOGWOOD PSYCHOLOGY CENTER FOR CHILDREN AND FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-945-4567
Mailing Address - Street 1:960 CORPORATE DR STE 111
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-8560
Mailing Address - Country:US
Mailing Address - Phone:919-945-4567
Mailing Address - Fax:
Practice Address - Street 1:960 CORPORATE DR STE 111
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-8560
Practice Address - Country:US
Practice Address - Phone:919-945-4567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health