Individual
GLEN BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CLINICAL PSYCHOLOGIS
Contact information
Practice address
2300 COMMONWEALTH DR, SUITE 100, CHARLOTTESVILLE, VA 22901-1622
(434) 812-4009
Mailing address
2300 COMMONWEALTH DR, SUITE 100, CHARLOTTESVILLE, VA 22901-1622
(434) 812-4009
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810002117
VA
103TC0700X
Clinical Psychologist
0810002117
VA
Other
Enumeration date
01/15/2014
Last updated
11/03/2015
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