Provider Demographics
NPI:1497002323
Name:BOWMAN, LINDA SUE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:SUE
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:LINDA
Other - Middle Name:SUE
Other - Last Name:ALTHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:DEPARTMENT OF COMM. SCIENCES & DIS.
Mailing Address - Street 2:CAMPUS BOX 4720, ILLINOIS STATE UNIVERSITY
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61790-4720
Mailing Address - Country:US
Mailing Address - Phone:309-438-3960
Mailing Address - Fax:309-438-5221
Practice Address - Street 1:DEPARTMENT OF COMM SCIENCES & DIS
Practice Address - Street 2:CAMPUS BOX 4720, ILLINOIS STATE UNIVERSITY
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61790-4720
Practice Address - Country:US
Practice Address - Phone:309-438-3960
Practice Address - Fax:309-438-5221
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146-000550235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist