Provider Demographics
NPI:1982089736
Name:BOWE, TERESA GUNTER (MSP, SSS-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:GUNTER
Last Name:BOWE
Suffix:
Gender:F
Credentials:MSP, SSS-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 WINDSOR PARK DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7953
Mailing Address - Country:US
Mailing Address - Phone:803-360-4319
Mailing Address - Fax:
Practice Address - Street 1:100 TARRAR RD.
Practice Address - Street 2:SUITE D
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072
Practice Address - Country:US
Practice Address - Phone:803-821-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist