Individual
MS. SALLY INDEPENDENCE BOWIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
10 MUZZEY ST, LEXINGTON, MA 02421-5222
(781) 674-9124
(781) 674-9126
Mailing address
6 BARBERRY ROAD, LEXINGTON, MA 02421-8004
(781) 674-9124
(781) 674-9126
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
102804
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P02455
BCBS
MA
Enumeration date
12/07/2006
Last updated
08/10/2016
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