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NICHOLAS BOWERSOX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
2215 FULLER RD, ANN ARBOR, MI 48105-2303
(734) 222-7447
Mailing address
3035 PRAIRIE CIRCLE TRL, ANN ARBOR, MI 48103-8322

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301014711
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6301014711
STATE OF MICHIGAN PSYCHOLOGIST LICENSE
MI
Enumeration date
05/10/2013
Last updated
05/10/2013
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