Provider Demographics
NPI:1982478269
Name:BOWMAN, AMBERLY RENEE (LPC-A)
Entity Type:Individual
Prefix:MISS
First Name:AMBERLY
Middle Name:RENEE
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VIDOR
Mailing Address - State:TX
Mailing Address - Zip Code:77662-3740
Mailing Address - Country:US
Mailing Address - Phone:409-769-8910
Mailing Address - Fax:409-769-8914
Practice Address - Street 1:1271 N MAIN ST
Practice Address - Street 2:
Practice Address - City:VIDOR
Practice Address - State:TX
Practice Address - Zip Code:77662-3740
Practice Address - Country:US
Practice Address - Phone:409-769-8910
Practice Address - Fax:409-769-8914
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93254101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor