Individual
MRS. TERRY RICH BOWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13 PARKSIDE LANE, BELFAST, ME 04915
(207) 338-1507
Mailing address
13 PARKSIDE LANE, BELFAST, ME 04915
(207) 338-1507
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
ALLS2056
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202240000
—
ME
Enumeration date
04/12/2007
Last updated
07/08/2007
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