Provider Demographics
NPI:1942509344
Name:BOWDRY, SINETRA (CCC- SLP)
Entity Type:Individual
Prefix:MS
First Name:SINETRA
Middle Name:
Last Name:BOWDRY
Suffix:
Gender:F
Credentials:CCC- SLP
Other - Prefix:
Other - First Name:SINETRA
Other - Middle Name:BOWDRY
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1305 DARES BEACH RD
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4208
Mailing Address - Country:US
Mailing Address - Phone:301-821-5849
Mailing Address - Fax:
Practice Address - Street 1:1305 DARES BEACH RD
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4208
Practice Address - Country:US
Practice Address - Phone:301-821-5849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist