Provider Demographics
NPI:1588952469
Name:BOWERS, CHRISTINE MICHELLE (MS)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MICHELLE
Last Name:BOWERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MICHELLE
Other - Last Name:WENGLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2300 COMMONWEALTH DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1894
Mailing Address - Country:US
Mailing Address - Phone:434-922-2345
Mailing Address - Fax:
Practice Address - Street 1:2300 COMMONWEALTH DR STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1894
Practice Address - Country:US
Practice Address - Phone:434-922-2345
Practice Address - Fax:434-922-2326
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA07170001423106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist