Provider Demographics
NPI:1336887470
Name:BOWES, MEGAN ALYSS
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:ALYSS
Last Name:BOWES
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 1:585 E SQUARE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-3143
Mailing Address - Country:US
Mailing Address - Phone:248-303-6693
Mailing Address - Fax:
Practice Address - Street 1:585 E SQUARE LAKE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-3143
Practice Address - Country:US
Practice Address - Phone:248-303-6693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker