1891061081 NPI number — MRS. ANDREA R.B. BOWEN MS, CCC-SLP

Table of content: CHARLES CROUSE MA, LMHC (NPI 1659047967)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891061081 NPI number — MRS. ANDREA R.B. BOWEN MS, CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOWEN
Provider First Name:
ANDREA
Provider Middle Name:
R.B.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891061081
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2500 N CHURCH STREET
Provider Second Line Business Mailing Address:
CHESHIRE SPEECH AND VOICE CENTER
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27405-4314
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-375-2240
Provider Business Mailing Address Fax Number:
336-375-2214

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CHESHIRE SPEECH AND VOICE CENTER
Provider Second Line Business Practice Location Address:
2500 N CHURCH STREET
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27405-4314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-375-2240
Provider Business Practice Location Address Fax Number:
336-375-2214
Provider Enumeration Date:
04/01/2012

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: 235Z00000X , with the licence number:  9443 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com