Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 102L00000X | Psychologist | PY9067 | FL |
Y | 103T00000X | Psychologist | PY9067 | FL |
N | 103G00000X | Clinical Psychologist | PY9067 | FL |
N | 103TC0700X | Clinical Psychologist | PY9067 | FL |
N | 103TC1900X | Counseling Psychologist | ||
N | 103TF0200X | Forensic Psychologist |
NPI | 1073871505 |
---|---|
Provider Name | Dr. Katie Bowman |
First Address | New Port Richey, FL 34653 |
Second Address | New Port Richey, FL 34653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2012 |
Last Update Date | 02/02/2016 |