Provider Information for 1205325917
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NICOLE BOWKER LPC, NCC
Sex: Female
NPI: 1205325917
Last Updated: 2024-06-14
Certification Date: 2024-06-14
Certification Date: 2024-06-14
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1205325917 | ||||||||
| Enumeration Date | 2018-05-08 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 7855 KITTY HAWK RD APT 1304 CONVERSE, TX 78109-1772 United States Phone: 630-701-5154 | Fax: | ||||||||
| Primary Practice Address | 900 NE LOOP 410 STE D200 SAN ANTONIO, TX 78209-1407 United States Phone: 210-822-2600 | Fax: | ||||||||
| Secondary Practice Address(es) | 4209 W SHAMROCK LN UNIT C 2600 DEKALB AVE STE J | ||||||||
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