Individual
MS. BARBARA BOWERS VICENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPA
Contact information
Practice address
6394 SHALLOWFORD RD, LEWISVILLE, NC 27023-9603
(336) 287-3817
(336) 946-2224
Mailing address
6394 SHALLOWFORD RD, LEWISVILLE, NC 27023-9603
(336) 287-3817
(336) 946-2224
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2449
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107126
—
NC
01
—
NCMC034609
VALUE OPTIONS PROVIDER #
NC
Enumeration date
10/17/2006
Last updated
07/08/2007
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