Basic Information
| Provider Information | |||||||||
| NPI: | 1972654572 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOWERS | ||||||||
| FirstName: | DANA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 775 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CHELSEA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481181383 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344751311 | ||||||||
| FaxNumber: | 7344754121 | ||||||||
| Practice Location | |||||||||
| Address1: | 775 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CHELSEA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481181383 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344751311 | ||||||||
| FaxNumber: | 7344754121 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103G00000X | 6301010523 | MI | Y | Behavioral Health & Social Service Providers | Clinical Neuropsychologist |
No ID Information.