Basic Information
| Provider Information | |||||||||
| NPI: | 1427331966 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOWLES | ||||||||
| FirstName: | WARREN | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | MS.ED, LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 402 S SILVER SPRINGS RD | ||||||||
| Address2: | |||||||||
| City: | CAPE GIRARDEAU | ||||||||
| State: | MO | ||||||||
| PostalCode: | 637037536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733341100 | ||||||||
| FaxNumber: | 5736514345 | ||||||||
| Practice Location | |||||||||
| Address1: | 406 N SPRING ST STE 2 | ||||||||
| Address2: | |||||||||
| City: | PERRYVILLE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 637751912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5735478305 | ||||||||
| FaxNumber: | 5736514345 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2011 | ||||||||
| LastUpdateDate: | 01/07/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 2013044732 | MO | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.