Provider Demographics
NPI:1528214954
Name:WARRICK, KERI BOWEN (MED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:BOWEN
Last Name:WARRICK
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:ANN
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, CCC-SLP
Mailing Address - Street 1:4045 CARBONNE CT
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-3204
Mailing Address - Country:US
Mailing Address - Phone:770-789-2620
Mailing Address - Fax:
Practice Address - Street 1:4045 CARBONNE CT
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-3204
Practice Address - Country:US
Practice Address - Phone:770-789-2620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006558235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist