Individual
DWAIN BOWLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
716 S MAIN ST, BROKEN ARROW, OK 74012-5527
(918) 367-1130
(918) 367-1180
Mailing address
PO BOX 1078, BRISTOW, OK 74010-1078
(918) 367-1130
(918) 367-1180
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
586
OK
Other
Enumeration date
01/20/2009
Last updated
01/20/2009
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