1235493552 NPI number — COURTNEY LEE BOWERS OTR/L

Table of content: ARIANA PATRICIA VERDUCCI LMHC (NPI 1225634900)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235493552 NPI number — COURTNEY LEE BOWERS OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOWERS
Provider First Name:
COURTNEY
Provider Middle Name:
LEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OTR/L
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MERRITT
Provider Other First Name:
COURTNEY
Provider Other Middle Name:
LEE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTR/L
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1235493552
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/09/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3217 SUGARBUSH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARROLLTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75007-2928
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-712-2669
Provider Business Mailing Address Fax Number:
972-712-4514

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10400 N CENTRAL EXPY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75231-2297
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-884-4390
Provider Business Practice Location Address Fax Number:
972-674-2616
Provider Enumeration Date:
07/02/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  114115 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 114115 . This is a "LICENSE FOR OCCUPATIONAL THERAPY" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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