Provider Demographics
NPI:1659114106
Name:BOWDRE, PATRISHA
Entity type:Individual
Prefix:
First Name:PATRISHA
Middle Name:
Last Name:BOWDRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 BARDSLEY ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02723-4036
Mailing Address - Country:US
Mailing Address - Phone:774-451-8536
Mailing Address - Fax:
Practice Address - Street 1:61 BARDSLEY ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-4036
Practice Address - Country:US
Practice Address - Phone:774-451-8536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician