Provider Demographics
NPI:1811275738
Name:BOWEN, ASHIRA
Entity type:Individual
Prefix:
First Name:ASHIRA
Middle Name:
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 1:2301 NW 122ND ST
Mailing Address - Street 2:APT 3516
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8447
Mailing Address - Country:US
Mailing Address - Phone:773-480-3799
Mailing Address - Fax:
Practice Address - Street 1:1330 N CLASSEN BLVD
Practice Address - Street 2:STE 214
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-6835
Practice Address - Country:US
Practice Address - Phone:405-601-6710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health