Provider Demographics
NPI:1881909018
Name:BOWEN, LISA SABATINE (MS)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:SABATINE
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:TURNER
Mailing Address - State:ME
Mailing Address - Zip Code:04282-4215
Mailing Address - Country:US
Mailing Address - Phone:207-212-9251
Mailing Address - Fax:207-225-2106
Practice Address - Street 1:54 COUNTY RD
Practice Address - Street 2:
Practice Address - City:TURNER
Practice Address - State:ME
Practice Address - Zip Code:04282-4215
Practice Address - Country:US
Practice Address - Phone:207-212-9251
Practice Address - Fax:207-225-2106
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPE771174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist