Provider Demographics
NPI:1386335677
Name:BOWER, RHIANNON (LLMSW)
Entity type:Individual
Prefix:
First Name:RHIANNON
Middle Name:
Last Name:BOWER
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 E KILGORE RD
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49002-0507
Mailing Address - Country:US
Mailing Address - Phone:269-249-7179
Mailing Address - Fax:269-459-7149
Practice Address - Street 1:246 E KILGORE RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-0507
Practice Address - Country:US
Practice Address - Phone:269-249-7179
Practice Address - Fax:269-459-7149
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511162981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical