Provider Demographics
NPI:1659807220
Name:BOWLING, LINDSEY RENEE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:RENEE
Last Name:BOWLING
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 WOODLAND TRL
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-9203
Mailing Address - Country:US
Mailing Address - Phone:606-425-1153
Mailing Address - Fax:
Practice Address - Street 1:555 BOURNE AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-1915
Practice Address - Country:US
Practice Address - Phone:606-679-7421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY172931235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist