Provider Demographics
NPI:1881812006
Name:BOWERSCK, STEPHANIE (SP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:BOWERSCK
Suffix:
Gender:F
Credentials:SP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:STROH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4835 NEW HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CRIDERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45806-2134
Mailing Address - Country:US
Mailing Address - Phone:937-548-9495
Mailing Address - Fax:937-548-3055
Practice Address - Street 1:1498 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-2454
Practice Address - Country:US
Practice Address - Phone:937-548-9495
Practice Address - Fax:937-548-3055
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist