Provider Demographics
NPI:1740672344
Name:BOWMAN, RONI (LCSW)
Entity type:Individual
Prefix:
First Name:RONI
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1249 LAKESIDE RD
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7354
Mailing Address - Country:US
Mailing Address - Phone:501-262-2766
Mailing Address - Fax:501-262-2544
Practice Address - Street 1:1249 LAKESIDE RD
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7354
Practice Address - Country:US
Practice Address - Phone:501-262-2766
Practice Address - Fax:501-262-2544
Is Sole Proprietor?:No
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1852-C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker