Provider Demographics
NPI:1770354185
Name:BOWEN, LILLIAN C
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:C
Last Name:BOWEN
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 1:3 PEBBLE LN
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:KY
Mailing Address - Zip Code:41230-5726
Mailing Address - Country:US
Mailing Address - Phone:606-225-2629
Mailing Address - Fax:
Practice Address - Street 1:147 SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-9118
Practice Address - Country:US
Practice Address - Phone:606-225-2629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical