Provider Demographics
NPI:1699078048
Name:BOWMAN, LINDA (LMSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4382 LAKE FOREST DR E
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-9683
Mailing Address - Country:US
Mailing Address - Phone:734-678-7709
Mailing Address - Fax:
Practice Address - Street 1:4382 LAKE FOREST DR E
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-9683
Practice Address - Country:US
Practice Address - Phone:734-678-7709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010101151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801010115OtherSTATE OF MICHIGAN