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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2202006803 | VA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bayside Children'S Therapy Network, Inc. | Speech-Language Pathologist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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- Danielle Joy Boyd
- Jennifer Owens Britt
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All providers in Gloucester, VA · Speech-Language Pathologist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.