Provider Demographics
NPI:1518371376
Name:BOWEN, PAIGE BURKINK (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:BURKINK
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:BURKINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1966 INWOOD RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7298
Mailing Address - Country:US
Mailing Address - Phone:972-883-3010
Mailing Address - Fax:972-883-3022
Practice Address - Street 1:2895 FACILITIES WAY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:972-883-3660
Practice Address - Fax:972-883-3622
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110035235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist