Provider Demographics
NPI:1528269834
Name:BOWERS, CHRISTY LAYTON (MCD)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:LAYTON
Last Name:BOWERS
Suffix:
Gender:F
Credentials:MCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 E BEVERLY WAY
Mailing Address - Street 2:UNIT 117
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-2057
Mailing Address - Country:US
Mailing Address - Phone:562-301-5194
Mailing Address - Fax:562-590-9058
Practice Address - Street 1:1900 E BEVERLY WAY
Practice Address - Street 2:UNIT 117
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-2057
Practice Address - Country:US
Practice Address - Phone:562-301-5194
Practice Address - Fax:562-590-9058
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP12538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist