Provider Demographics
NPI:1356465736
Name:BOWEN, LINDA TEDDER (MS)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:TEDDER
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 CUTHRELL ST
Mailing Address - Street 2:
Mailing Address - City:BELHAVEN
Mailing Address - State:NC
Mailing Address - Zip Code:27810-1613
Mailing Address - Country:US
Mailing Address - Phone:252-943-2871
Mailing Address - Fax:
Practice Address - Street 1:851 CUTHRELL ST
Practice Address - Street 2:
Practice Address - City:BELHAVEN
Practice Address - State:NC
Practice Address - Zip Code:27810-1613
Practice Address - Country:US
Practice Address - Phone:252-943-2871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2141235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist