Provider Demographics
NPI:1285274076
Name:BOWMAN, MELISSA BOWMAN
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:BOWMAN
Last Name:BOWMAN
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 1:143 VAUGHN SOUTH FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-6217
Mailing Address - Country:US
Mailing Address - Phone:970-370-4748
Mailing Address - Fax:
Practice Address - Street 1:143 VAUGHN SOUTH FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-6217
Practice Address - Country:US
Practice Address - Phone:970-370-4748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-09
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty