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Individual

JESSICA R BOWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
518 MARKHAM DR, SLIDELL, LA 70458-5236
(985) 778-6350
Mailing address
63069 HUMMINGBIRD LN, MANDEVILLE, LA 70448-7306
(985) 778-6350

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7416233001
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7416233001
LA
Enumeration date
01/26/2021
Last updated
01/26/2021
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