Healthcare Provider Details

I. General information

NPI: 1003362542
Provider Name (Legal Business Name): SCOTT HOWER SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 08/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 LAFAYETTE AVE SE SUITE 400
GRAND RAPIDS MI
49503-4677
US

IV. Provider business mailing address

100 MICHIGAN ST NE MC 845
GRAND RAPIDS MI
49503-2560
US

V. Phone/Fax

Practice location:
  • Phone: 616-486-6870
  • Fax: 616-454-6898
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101000949
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: