Provider Demographics
NPI:1982016952
Name:BOWMAN, ALLYSON (LPC-MHSP)
Entity Type:Individual
Prefix:MS
First Name:ALLYSON
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 DUANE RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-2309
Mailing Address - Country:US
Mailing Address - Phone:423-505-2005
Mailing Address - Fax:
Practice Address - Street 1:4501 HIXSON PIKE
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-5035
Practice Address - Country:US
Practice Address - Phone:423-505-2005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2976101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional