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Individual

DIANE APRIL BOWLUS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
OT/L

Contact information

Practice address
513 AZURE DR, CAMP VERDE, AZ 86322-7276
(928) 567-7330
(928) 567-4146
Mailing address
PO BOX 640, CAMP VERDE, AZ 86322-0640
(928) 567-7330
(928) 567-4146

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
1785
AZ
225XH1300X
Human Factors Occupational Therapist
1785
AZ
225XP0200X
Pediatric Occupational Therapist
Primary
1785
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
556003
AHCCCS
AZ
Enumeration date
07/26/2005
Last updated
09/11/2025
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