Provider Demographics
NPI:1912471517
Name:BOWERS, PATRICIA LYN
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LYN
Last Name:BOWERS
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 1:324 E ANTIETAM ST STE 307A
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5768
Mailing Address - Country:US
Mailing Address - Phone:667-600-2140
Mailing Address - Fax:667-600-4076
Practice Address - Street 1:324 E ANTIETAM ST STE 307A
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5768
Practice Address - Country:US
Practice Address - Phone:667-600-2140
Practice Address - Fax:667-600-4076
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3238101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health