Provider Demographics
NPI:1285140582
Name:BOWIE, DIONNE
Entity type:Individual
Prefix:
First Name:DIONNE
Middle Name:
Last Name:BOWIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 GARCIA CT UNIT M
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-1273
Mailing Address - Country:US
Mailing Address - Phone:706-631-7474
Mailing Address - Fax:
Practice Address - Street 1:1403 GARCIA CT UNIT M
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-1273
Practice Address - Country:US
Practice Address - Phone:706-631-7474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6514101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional