Provider Demographics
NPI:1831378595
Name:BOWEN, SUSAN S (MA,CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:S
Last Name:BOWEN
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 1:3315 RAIN CT
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28638-9263
Mailing Address - Country:US
Mailing Address - Phone:828-396-8541
Mailing Address - Fax:
Practice Address - Street 1:322 NUWAY CIR
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-3656
Practice Address - Country:US
Practice Address - Phone:828-758-7326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6856235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist