Individual
MICHELLE BOWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, CSW
Contact information
Practice address
1258 W SOUTH JORDAN PKWY STE 202, SOUTH JORDAN, UT 84095-4712
(801) 792-8556
Mailing address
1258 W SOUTH JORDAN PKWY STE 202, SOUTH JORDAN, UT 84095-4712
(801) 792-8556
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
7718076-3502
UT
Other
Enumeration date
08/15/2013
Last updated
08/15/2013
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