| Lea Bowman Lcsw | |
|
2714 N Tamarack Dr Boise ID 83703-4427 | |
| (208) 576-7411 | |
| Not Available |
| Full Name | Lea Bowman Lcsw |
|---|---|
| Speciality | Social Worker |
| Location | 2714 N Tamarack Dr, Boise, Idaho |
| Authorized Official Name and Position | Lea Bowman (OWNER) |
| Authorized Official Contact | 2085767411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lea Bowman Lcsw 2714 N Tamarack Dr Boise ID 83703-4427 Ph: () - | Lea Bowman Lcsw 2714 N Tamarack Dr Boise ID 83703-4427 Ph: (208) 576-7411 |
| NPI Number | 1023680048 |
|---|---|
| Provider Enumeration Date | 07/12/2021 |
| Last Update Date | 07/12/2021 |
| Certification Date | 07/12/2021 |
| Medicare PECOS PAC ID | 9335538636 |
|---|---|
| Medicare Enrollment ID | O20211108000663 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023680048 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lea K Bowman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629557905 PECOS PAC ID: 7113271636 Enrollment ID: I20181119002032 |
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