Provider Demographics
NPI:1730310434
Name:BOWERS, SHAUNA KAYE (MAED)
Entity Type:Individual
Prefix:MRS
First Name:SHAUNA
Middle Name:KAYE
Last Name:BOWERS
Suffix:
Gender:F
Credentials:MAED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 MICHAEL DR
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-2920
Mailing Address - Country:US
Mailing Address - Phone:307-672-6001
Mailing Address - Fax:
Practice Address - Street 1:649 MICHAEL DR
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-2920
Practice Address - Country:US
Practice Address - Phone:307-672-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services