Individual
TRICIA BOWERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFTA
Contact information
Practice address
3265 INTERTECH DR, ANGOLA, IN 46703-7325
(260) 665-9494
(260) 665-9496
Mailing address
PO BOX 817, KENDALLVILLE, IN 46755-0817
(260) 347-2453
(260) 347-2456
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
85000267A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85000267A
LICENSE
IN
Enumeration date
05/31/2016
Last updated
05/31/2016
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