Provider Demographics
NPI:1992076970
Name:BOWEN, REBECCA (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2993 MATHERS WAY
Mailing Address - Street 2:2993 MATHERS WAY
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-2629
Mailing Address - Country:US
Mailing Address - Phone:330-840-1188
Mailing Address - Fax:
Practice Address - Street 1:31005 BAINBRIDGE RD STE 7
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-6401
Practice Address - Country:US
Practice Address - Phone:440-498-1100
Practice Address - Fax:440-498-1149
Is Sole Proprietor?:No
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH9525235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist