Provider Demographics
NPI:1407512254
Name:BOWLER, GILLIAN LEIGH (SLPA)
Entity Type:Individual
Prefix:
First Name:GILLIAN
Middle Name:LEIGH
Last Name:BOWLER
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3954 ROBIN CT
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8343
Mailing Address - Country:US
Mailing Address - Phone:209-777-4599
Mailing Address - Fax:
Practice Address - Street 1:3954 ROBIN CT
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-8343
Practice Address - Country:US
Practice Address - Phone:209-777-4599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64712355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant