Individual
JALESA BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
507 W MAIN ST, LOUISVILLE, MS 39339-2559
(662) 773-9377
(662) 773-9025
Mailing address
302 N JACKSON ST, STARKVILLE, MS 39759-2504
(662) 323-9318
(662) 323-5553
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/05/2019
Last updated
03/05/2019
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