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Individual

MR. MATHEW G BOWDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CSW

Contact information

Practice address
1309 BENNETT AVE, BURLEY, ID 83318-2676
(208) 678-0101
Mailing address
794 EASTLAND DR, TWIN FALLS, ID 83301-6856
(208) 737-6718

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
70059863502
UT
1041C0700X
Clinical Social Worker
Primary
LCSW-38761
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
260022408
RAILROAD MEDICARE
UT
05
876000308007
UT
Enumeration date
05/19/2008
Last updated
03/17/2021
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