Individual
ELEANOR A BOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
119 N MARKET ST, BUSHNELL, FL 33513-6107
(352) 793-4126
(352) 360-6582
Mailing address
1898 W C 476, BUSHNELL, FL 33513-3524
(352) 793-4126
(352) 360-6582
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW 2454
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
768183600
—
FL
01
—
AC851
MEDICARE PTAN
FL
Enumeration date
03/01/2007
Last updated
09/20/2012
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