Provider Demographics
NPI:1437914165
Name:BOWERS-THOMPSON, JADA ELISE (MCBS)
Entity Type:Individual
Prefix:MS
First Name:JADA
Middle Name:ELISE
Last Name:BOWERS-THOMPSON
Suffix:
Gender:F
Credentials:MCBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 VARDEN DR STE C
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-5275
Mailing Address - Country:US
Mailing Address - Phone:803-514-9413
Mailing Address - Fax:
Practice Address - Street 1:35 VARDEN DR STE C
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-5275
Practice Address - Country:US
Practice Address - Phone:803-514-9413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist