Provider Demographics
NPI:1083629406
Name:COWAN, ROSEMARY HANNAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:HANNAN
Last Name:COWAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 VOGEL RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-7832
Mailing Address - Country:US
Mailing Address - Phone:812-477-5000
Mailing Address - Fax:812-477-5002
Practice Address - Street 1:5401 VOGEL RD
Practice Address - Street 2:SUITE 140
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-7832
Practice Address - Country:US
Practice Address - Phone:812-477-5000
Practice Address - Fax:812-477-5002
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22002940A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200219650AMedicaid