Provider Demographics
NPI:1306179965
Name:BOWDEN, CARLA CELESTE (OT)
Entity Type:Individual
Prefix:MS
First Name:CARLA
Middle Name:CELESTE
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2718 RIVIERA DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-4258
Mailing Address - Country:US
Mailing Address - Phone:214-535-5788
Mailing Address - Fax:
Practice Address - Street 1:2301 FOREST LN
Practice Address - Street 2:SUITE 200
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7954
Practice Address - Country:US
Practice Address - Phone:214-501-1460
Practice Address - Fax:214-501-1467
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11785225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist