Provider Demographics
NPI:1033281738
Name:MCCOWN, PATRICIA HERNILDA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:HERNILDA
Last Name:MCCOWN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 HARBOR INN DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-5616
Mailing Address - Country:US
Mailing Address - Phone:305-989-6911
Mailing Address - Fax:
Practice Address - Street 1:6862 NW 169TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4210
Practice Address - Country:US
Practice Address - Phone:786-615-8426
Practice Address - Fax:786-801-1724
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA16920235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8914672Medicaid