Provider Demographics
NPI:1699954404
Name:BOWEN, CYNTHIA WILLIAMS (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:WILLIAMS
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2439 BOND AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1204
Mailing Address - Country:US
Mailing Address - Phone:727-797-6250
Mailing Address - Fax:727-797-6250
Practice Address - Street 1:13575 58TH N ST 200
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-3739
Practice Address - Country:US
Practice Address - Phone:727-430-3932
Practice Address - Fax:855-374-5972
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist