Healthcare Provider Details

I. General information

NPI: 1518402320
Provider Name (Legal Business Name): LAURIN BOWLING M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2017
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3860 DOBIE RD
OKEMOS MI
48864-3704
US

IV. Provider business mailing address

2410 N HACKER RD
HOWELL MI
48855-9079
US

V. Phone/Fax

Practice location:
  • Phone: 517-381-6100
  • Fax:
Mailing address:
  • Phone: 810-623-1698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number0000004654
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: