Provider Demographics
NPI:1316728769
Name:BOWERS, ABBY (CMHW)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:BOWERS
Suffix:
Gender:F
Credentials:CMHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 LANE 12
Mailing Address - Street 2:
Mailing Address - City:LOVELL
Mailing Address - State:WY
Mailing Address - Zip Code:82431-9555
Mailing Address - Country:US
Mailing Address - Phone:307-548-6543
Mailing Address - Fax:
Practice Address - Street 1:116 SOUTH 3RD STREET
Practice Address - Street 2:
Practice Address - City:BASIN
Practice Address - State:WY
Practice Address - Zip Code:82410
Practice Address - Country:US
Practice Address - Phone:307-548-6543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor