MEDICARE: MRS. CHLOE BOWDEN BCBA

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1295184018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHLOE BOWDEN BCBA

Provider Business Mailing Address
First Line	:	369 NORWOOD AVE SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49506-1716
Country	:	US
Telephone Number	:	616-796-4345
Fax Number	:

Provider Business Practice Location Address
First Line	:	2938 HANSEN RD
Second Line	:
City	:	WEST BRANCH
State	:	MI
Zip	:	48661-9317
Country	:	US
Telephone Number	:	989-787-0522
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2016
Last Update Date	:	01/16/2025

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