Provider Demographics
NPI:1083340665
Name:BOWEN, MIKALA DEIANDRA (MS, CF-SLP)
Entity Type:Individual
Prefix:MISS
First Name:MIKALA
Middle Name:DEIANDRA
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9330 MAIN ST APT 357
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-4569
Mailing Address - Country:US
Mailing Address - Phone:803-521-2258
Mailing Address - Fax:
Practice Address - Street 1:6402 LANGFIELD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-1098
Practice Address - Country:US
Practice Address - Phone:713-460-6165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist