Individual provider · NPI-1
Mara Jeanne Gowen
Specialist/Technologist, Athletic Trainer · Brighton, MA
NPI number1942764048
StatusActive
Last updated in NPPESJan 23, 2019
Details
- NPI
- 1942764048
- Entity type
- Individual (NPI-1)
- Name
- Mara Jeanne Gowen
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 23, 2019
- Last updated
- Jan 23, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
8 Vinal St Apt 1Brighton, MA 02135-7633
Phone 508-510-9680
Mailing address
8 Vinal St Apt 1Brighton, MA 02135-7633
Phone 508-510-9680
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