Provider Demographics
NPI:1952005050
Name:BOWEN, AARON
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:BOWEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3890 DUNN AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-6428
Mailing Address - Country:US
Mailing Address - Phone:904-765-0664
Mailing Address - Fax:
Practice Address - Street 1:3890 DUNN AVE STE 104
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-6428
Practice Address - Country:US
Practice Address - Phone:904-765-0664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health