Provider Demographics
NPI:1447501408
Name:BOWEN, MONIQUE S (PHD)
Entity type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:S
Last Name:BOWEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 RIVERSIDE DR
Mailing Address - Street 2:SUITE 1W
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3724
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 RIVERSIDE DR
Practice Address - Street 2:SUITE 1W
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3724
Practice Address - Country:US
Practice Address - Phone:917-756-4597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-30
Last Update Date:2012-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist