Individual
RUSSELL WILLIAM BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
11225 N 28TH DR STE D220C, PHOENIX, AZ 85029-5697
(480) 680-1240
(480) 680-1245
Mailing address
1308 W 16TH ST, TEMPE, AZ 85281-6211
(614) 364-3794
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LAC-23376
AZ
Other
Enumeration date
08/27/2025
Last updated
08/27/2025
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