Individual
PAGE MARC BOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Mailing address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
76673813503
UT
1041C0700X
Clinical Social Worker
Primary
7667381-3502
UT
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/10/2015
Last updated
05/26/2021
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