MEDICARE: SHELBY JEAN BOWEN M.S., CCC-SLP

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	9382	LA

General Provider Information

NPI Number	:	1780367193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBY JEAN BOWEN M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	202 RUE IBERVILLE
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-3295
Country	:	US
Telephone Number	:	337-521-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 MUDD AVE
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70501-4512
Country	:	US
Telephone Number	:	337-521-7500
Fax Number	:

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

Provider Enumeration Date	:	08/11/2023
Last Update Date	:	03/11/2026

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Directions to “ SHELBY JEAN BOWEN M.S., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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