Provider Demographics
NPI:1306940895
Name:BOWERS, SHIRLEY JEAN (LSW, BA)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:JEAN
Last Name:BOWERS
Suffix:
Gender:F
Credentials:LSW, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 512
Mailing Address - Street 2:
Mailing Address - City:OKOLONA
Mailing Address - State:MS
Mailing Address - Zip Code:38860-0512
Mailing Address - Country:US
Mailing Address - Phone:662-447-2437
Mailing Address - Fax:
Practice Address - Street 1:2434 S EASON BLVD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-6942
Practice Address - Country:US
Practice Address - Phone:662-844-1717
Practice Address - Fax:662-680-6416
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health