MEDICARE: KATHARINE LYNN COWEN

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	235Z00000X	Speech-Language Pathologist	7101003563	MI

General Provider Information

NPI Number	:	1588328728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHARINE LYNN COWEN

Provider Business Mailing Address
First Line	:	3731 WILDER RD
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-2365
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3731 WILDER RD
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-2365
Country	:	US
Telephone Number	:	989-860-5176
Fax Number	:

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

Provider Enumeration Date	:	10/25/2021
Last Update Date	:	10/25/2021

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Directions to “ KATHARINE LYNN COWEN ” Practice Location

Language	Start Address	Practice Location

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