Provider Demographics
NPI:1467706945
Name:BOWMAN, MICHELLE SLUSZKA (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:SLUSZKA
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 S HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-2426
Mailing Address - Country:US
Mailing Address - Phone:904-806-2778
Mailing Address - Fax:
Practice Address - Street 1:1830 S ALMA SCHOOL RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3056
Practice Address - Country:US
Practice Address - Phone:480-902-0771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5246225X00000X
AL3322225X00000X
GA5099225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist