Provider Demographics
NPI:1194843631
Name:DOWER, NIKIA RAE (MS CCC SLP BCBA LBA)
Entity Type:Individual
Prefix:
First Name:NIKIA
Middle Name:RAE
Last Name:DOWER
Suffix:
Gender:F
Credentials:MS CCC SLP BCBA LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9845 BUSINESS WAY
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4152
Mailing Address - Country:US
Mailing Address - Phone:703-618-6180
Mailing Address - Fax:703-542-3206
Practice Address - Street 1:9845 BUSINESS WAY
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4152
Practice Address - Country:US
Practice Address - Phone:703-618-6180
Practice Address - Fax:703-542-3206
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202001282235Z00000X
VA0133000035103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0133000035OtherLICENSED BEHAVIOR ANALYST - VIRGINIA BOARD OF MEDICINE
01032747OtherASHA CCC
1052204OtherBCBA CERTIFICATION
VA2202001282OtherVA SLP LICENSE