Individual
ANNETTE BOUW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
11518 E APACHE TRL STE 129, APACHE JUNCTION, AZ 85120-3572
(480) 784-1514
Mailing address
1205 N CAMBRIDGE CIR, CHANDLER, AZ 85225-1601
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC-19957
STATE LICENSE
AZ
Enumeration date
06/09/2022
Last updated
06/09/2022
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