Kathryn Anna Bowen, M.ED.

Individual provider Active NPI Speech-Language Pathologist · Gloucester, VA

NPI 1033468012 · NPPES record last updated Sep 5, 2012

Key facts

NPI
1033468012
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2202006803 (VA)
Practice address
6688 Main St
Gloucester, VA 23061-5194
Phone
(804) 210-1555
NPI assigned
Sep 5, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
2202006803VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Children'S Therapy Network, Inc. Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202006803 VA Yes

Addresses

Primary practice location

6688 Main St
Gloucester, VA 23061-5194

Mailing address

PO Box 599
Mathews, VA 23109-0599
Phone (804) 815-9215

Other providers in Gloucester, VA

All providers in Gloucester, VA · Speech-Language Pathologist in Virginia

Sources for this page

Verify at the official NPI Registry.