Provider Demographics
NPI:1033638101
Name:BOWSHER, KATIE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:
Last Name:BOWSHER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 E 600 N
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-9783
Mailing Address - Country:US
Mailing Address - Phone:765-490-6935
Mailing Address - Fax:
Practice Address - Street 1:1328 E 600 N
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-9783
Practice Address - Country:US
Practice Address - Phone:765-490-6935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22006577A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist