Provider Demographics
NPI:1649970138
Name:BOWERS, LISA (CA AND NEUROFEEDBACK)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:BOWERS
Suffix:
Gender:F
Credentials:CA AND NEUROFEEDBACK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6002 W ALAMEDA RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-3502
Mailing Address - Country:US
Mailing Address - Phone:602-828-5993
Mailing Address - Fax:
Practice Address - Street 1:6002 W ALAMEDA RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310-3502
Practice Address - Country:US
Practice Address - Phone:602-828-5993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator