Provider Demographics
NPI:1356787295
Name:BOWKER, JULIE (MT-BC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BOWKER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 BLAKE RD N
Mailing Address - Street 2:APT 203
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-3402
Mailing Address - Country:US
Mailing Address - Phone:651-955-5154
Mailing Address - Fax:
Practice Address - Street 1:320 BLAKE RD N
Practice Address - Street 2:APT 203
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-3402
Practice Address - Country:US
Practice Address - Phone:651-955-5154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-19
Last Update Date:2013-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN671160000020225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist