Provider Demographics
NPI:1710280417
Name:TOWERS, GEOVANNA (MS SLP CCC)
Entity Type:Individual
Prefix:
First Name:GEOVANNA
Middle Name:
Last Name:TOWERS
Suffix:
Gender:F
Credentials:MS SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WYNDGATE DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:12577-5409
Mailing Address - Country:US
Mailing Address - Phone:845-497-7289
Mailing Address - Fax:
Practice Address - Street 1:1145 LITTLE BRITAIN RD
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-5979
Practice Address - Country:US
Practice Address - Phone:845-564-1855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-19
Last Update Date:2010-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019745-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist