Provider Demographics
NPI:1669031316
Name:BOWYER, ASHLYN RENEE
Entity Type:Individual
Prefix:
First Name:ASHLYN
Middle Name:RENEE
Last Name:BOWYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLYN
Other - Middle Name:RENEE
Other - Last Name:TRYON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4735 E HARMONY CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-3333
Mailing Address - Country:US
Mailing Address - Phone:480-252-4752
Mailing Address - Fax:
Practice Address - Street 1:1334 E CHANDLER BLVD STE A-501
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-6267
Practice Address - Country:US
Practice Address - Phone:480-207-5975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant