Healthcare Provider Details

I. General information

NPI: 1750520078
Provider Name (Legal Business Name): BOWERS THERAPY SERVICES P.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2009
Last Update Date: 04/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 N LA PAZ ST
DEWEY AZ
86327-7147
US

IV. Provider business mailing address

422 N LA PAZ ST
DEWEY AZ
86327-7147
US

V. Phone/Fax

Practice location:
  • Phone: 928-899-0440
  • Fax:
Mailing address:
  • Phone: 928-899-0374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP5198
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP5433
License Number StateAZ

VIII. Authorized Official

Name: MRS. JENNIFER BOWERS
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: M.S., CCC-SLP
Phone: 928-899-0374