Provider Demographics
NPI:1487603890
Name:BOWES, TERRY ANNE (LICSW)
Entity type:Individual
Prefix:MS
First Name:TERRY
Middle Name:ANNE
Last Name:BOWES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 MAYNARD ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-2317
Mailing Address - Country:US
Mailing Address - Phone:781-572-5394
Mailing Address - Fax:
Practice Address - Street 1:319 LITTLETON RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-4126
Practice Address - Country:US
Practice Address - Phone:781-572-5394
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10274821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP22397Medicare ID - Type Unspecified