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NPI Code Detail

MEDICARE: SAVANNAH KATHRYN BOWMAN

MEDICARE: SAVANNAH KATHRYN BOWMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1558107409
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAVANNAH KATHRYN BOWMAN
Provider Business Mailing Address
First Line : 2971 EDBILLELLIS RD
Second Line :
City : N CHARLESTON
State : SC
Zip : 29406-9051
Country : US
Telephone Number : 184-382-6120
Fax Number :
Provider Business Practice Location Address
First Line : 1711 CENTRAL AVE
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-9320
Country : US
Telephone Number : 843-934-2697
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2024
Last Update Date : 07/01/2024

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