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General NPI Number Information
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NPI Number | 1083340665
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Entity Type | Individual
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Provider Name | MIKALA DEIANDRA BOWEN M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 1051 S A ST
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City | OXNARD
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State | CA
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Zip | 93030-7442
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Country | US
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Telephone | 805-385-1501
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Fax |
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Provider Business Mailing Address
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Address Line | 401 W 25TH ST APT 5201
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City | HOUSTON
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State | TX
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Zip | 77008-4611
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Country | US
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Telephone | 803-521-2258
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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