Most Relevant Information
Provider Data
| NPI Number: | 1003079005 |
| Provider Name: | BREANA S BOWSHER MSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/09/2008 |
| Last Updated: | 03/15/2012 |
Provider Practice Location
415 E MADISON ST
SOUTH BEND
IN
466172322
Practice Location Phone/Fax
| Phone: | 5742831234 |
| Fax: | 5742831361 |
Provider Mailing Location
PO BOX 809
GOSHEN
IN
465270809
Provider Mailing Phone/Fax
| Phone: | 5745331234 |
| Fax: | 5745372652 |