Provider Demographics
NPI:1972774487
Name:BOWLING, PAIGE ALISON (MA,CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:ALISON
Last Name:BOWLING
Suffix:
Gender:F
Credentials:MA,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2714 W EXECUTIVE CIR
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-5961
Mailing Address - Country:US
Mailing Address - Phone:417-581-3632
Mailing Address - Fax:
Practice Address - Street 1:2714 W EXECUTIVE CIR
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-5961
Practice Address - Country:US
Practice Address - Phone:417-581-3632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO104297235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist