Individual
MR. JONATHAN BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4510 N 37TH AVE, PHOENIX, AZ 85019-3206
(602) 336-2990
Mailing address
4510 N 37TH AVE, PHOENIX, AZ 85019-3206
(602) 336-2990
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
594508
—
AZ
Enumeration date
01/30/2007
Last updated
07/09/2007
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