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Individual

MARY E BOWMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMFT, APC

Contact information

Practice address
3939 OLD FLOWERY BRANCH RD, OAKWOOD, GA 30566-2545
(770) 654-4332
Mailing address
3939 OLD FLOWERY BRANCH RD, OAKWOOD, GA 30566-2545
(770) 654-4332

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001739
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
84-4861287
IRS
GA
Enumeration date
02/25/2020
Last updated
02/25/2020
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