Provider Demographics
NPI:1861190423
Name:BOWMAN, KARA MARIE
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:MARIE
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 S CEDAR ST STE 400
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-1590
Mailing Address - Country:US
Mailing Address - Phone:517-898-9664
Mailing Address - Fax:517-883-5005
Practice Address - Street 1:624 S CEDAR ST STE 400
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-1590
Practice Address - Country:US
Practice Address - Phone:517-898-9664
Practice Address - Fax:517-883-5005
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101008529235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist