Provider Demographics
NPI:1558973214
Name:BOWERS, JENNY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:BOWERS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2382 BIRCH VIEW DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-9440
Mailing Address - Country:US
Mailing Address - Phone:336-314-9614
Mailing Address - Fax:
Practice Address - Street 1:4008 MENDENHALL OAKS PKWY STE 101
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8302
Practice Address - Country:US
Practice Address - Phone:336-314-9614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-23
Last Update Date:2020-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6681235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist