Provider Demographics
NPI:1649438136
Name:BOWDEN, ELIZABETH G (MA CCC-A)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:G
Last Name:BOWDEN
Suffix:
Gender:
Credentials:MA CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6084
Mailing Address - Country:US
Mailing Address - Phone:314-543-6979
Mailing Address - Fax:
Practice Address - Street 1:5204 W REDBUD ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8936
Practice Address - Country:US
Practice Address - Phone:479-636-0110
Practice Address - Fax:479-631-0491
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA #94231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist