Provider Demographics
NPI:1356510093
Name:BOWMAN, SARAH V (MA, CCC SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:V
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:MA, CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 7TH ST W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-3009
Mailing Address - Country:US
Mailing Address - Phone:651-225-4558
Mailing Address - Fax:651-225-9474
Practice Address - Street 1:561 7TH ST W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-3009
Practice Address - Country:US
Practice Address - Phone:651-225-4558
Practice Address - Fax:651-225-9474
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8184235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist