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NPI Code Detail

MEDICARE: MS. THERESA SHARON BOWEN M.A. CCC-SLP

MEDICARE: MS. THERESA SHARON BOWEN M.A. 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
1235Z00000XSpeech-Language Pathologist086081-1NY

General Provider Information

NPI Number : 1821243270
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. THERESA SHARON BOWEN M.A. CCC-SLP
Provider Business Mailing Address
First Line : 40 FLEETWOOD AVE APT 5A
Second Line :
City : MOUNT VERNON
State : NY
Zip : 10552-2858
Country : US
Telephone Number : 914-573-6359
Fax Number :
Provider Business Practice Location Address
First Line : 40 FLEETWOOD AVE APT 5A
Second Line :
City : MOUNT VERNON
State : NY
Zip : 10552-2858
Country : US
Telephone Number : 914-573-6359
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2008
Last Update Date : 11/26/2008

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Directions to “ MS. THERESA SHARON BOWEN M.A. CCC-SLP” Practice Location

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