Provider Demographics
NPI:1912075045
Name:BOWMAN, MARTHA B (LMHC, LCAC)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:B
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LMHC, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 204
Mailing Address - Street 2:
Mailing Address - City:MOORELAND
Mailing Address - State:IN
Mailing Address - Zip Code:47360-0204
Mailing Address - Country:US
Mailing Address - Phone:765-524-4149
Mailing Address - Fax:
Practice Address - Street 1:8492 FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:IN
Practice Address - Zip Code:47346-9643
Practice Address - Country:US
Practice Address - Phone:765-524-4149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health