Provider Demographics
NPI:1972081180
Name:BOWERMAN, DAWN L (HAD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:L
Last Name:BOWERMAN
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 WEHRLE DR STE 3
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7381
Mailing Address - Country:US
Mailing Address - Phone:716-800-5440
Mailing Address - Fax:716-706-1340
Practice Address - Street 1:2801 WEHRLE DR STE 3
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7381
Practice Address - Country:US
Practice Address - Phone:716-633-2137
Practice Address - Fax:716-706-1340
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000054901237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist