Provider Demographics
NPI:1033968946
Name:BOWMAN, SARA (ALC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6153 VALLEY STATION DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35124-3123
Mailing Address - Country:US
Mailing Address - Phone:615-788-4562
Mailing Address - Fax:
Practice Address - Street 1:350 OVERBROOK RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35213-4332
Practice Address - Country:US
Practice Address - Phone:205-824-8320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC04632101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor