Provider Demographics
NPI:1528873700
Name:BOWLES, ANDREA LYNN-GARCIA
Entity type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:LYNN-GARCIA
Last Name:BOWLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DREA
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:544 FERNDALE AVE NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49534-3530
Mailing Address - Country:US
Mailing Address - Phone:616-223-0302
Mailing Address - Fax:
Practice Address - Street 1:544 FERNDALE AVE NW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49534-3530
Practice Address - Country:US
Practice Address - Phone:616-223-0302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician