Individual
BREANNE BOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 LASER RD NE, RIO RANCHO, NM 87124-4517
(505) 962-1242
Mailing address
500 LASER RD NE, RIO RANCHO, NM 87124-4517
(505) 962-1242
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
403947
NM
Other
Enumeration date
01/28/2022
Last updated
01/28/2022
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