Provider Demographics
NPI:1518738905
Name:BOWMAN, PAIGE ELISE (COTA)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:ELISE
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 ORCHARD GROVE DR # A
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-1411
Mailing Address - Country:US
Mailing Address - Phone:757-477-4668
Mailing Address - Fax:
Practice Address - Street 1:715 ARGYLL ST
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3105
Practice Address - Country:US
Practice Address - Phone:757-477-4668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131002620224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant