Basic Information
| Provider Information | |||||||||
| NPI: | 1780030726 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOWERS | ||||||||
| FirstName: | JOSH | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 750 N FREEDOM BLVD | ||||||||
| Address2: | |||||||||
| City: | PROVO | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846011677 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013734760 | ||||||||
| FaxNumber: | 8013730639 | ||||||||
| Practice Location | |||||||||
| Address1: | 39 S 800 E | ||||||||
| Address2: | |||||||||
| City: | SPRINGVILLE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846631539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8017351682 | ||||||||
| FaxNumber: | 8014266464 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2016 | ||||||||
| LastUpdateDate: | 12/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041S0200X | UT | N | Behavioral Health & Social Service Providers | Social Worker | School | 106H00000X | 10371756-3902 | UT | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.