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Contact Information

BRYAN W BOVITZ, PHD
208 CASABLANCA AVE.
27 SGOMH
CANNON AFB, NM88101-5014
 Phone: 575-784-1108
 Fax: 575-784-4624
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BRYAN W BOVITZ · (Male)

NPI # 1689824518
Status Active
Credentials PHD
Entity Individual
Enumeration date 09/29/2008
Last updated 03/07/2025 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • WA License # PY00003930
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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