Provider Demographics
NPI:1396429718
Name:BOWMAN, SAKEENA JENTAE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:SAKEENA
Middle Name:JENTAE
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 BLENHIEM FARM LN
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-2047
Mailing Address - Country:US
Mailing Address - Phone:904-327-6000
Mailing Address - Fax:
Practice Address - Street 1:1501 BLENHIEM FARM LN
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-2047
Practice Address - Country:US
Practice Address - Phone:904-328-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA02891224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant