Individual
PHYLLIS IRENE BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LISW-S
Contact information
Practice address
3330 W 4000 S APT H105, WEST HAVEN, UT 84401-9547
(513) 551-7664
Mailing address
3330 W 4000 S APT H105, WEST HAVEN, UT 84401-9547
(513) 551-7664
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1201300
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0155000
—
OH
01
—
12639231
CAQH
OH
Enumeration date
03/09/2010
Last updated
09/17/2024
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