Provider Demographics
NPI:1255599221
Name:BOWER, CAROLYN ROSE (AUD, CNIM, BCS-IOM)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:ROSE
Last Name:BOWER
Suffix:
Gender:F
Credentials:AUD, CNIM, BCS-IOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4623 TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-3854
Mailing Address - Country:US
Mailing Address - Phone:619-341-3971
Mailing Address - Fax:
Practice Address - Street 1:2815 CAMINO DEL RIO S
Practice Address - Street 2:SUITE 220
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3815
Practice Address - Country:US
Practice Address - Phone:858-279-6772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2605231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist