Active NPI
Deidre Fowler, M.A., CCC-SLP
- Speech-Language Pathologist
- Syracuse, NY
National Provider Identifier
1487069191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 023350
- Practice address
- 304 Westfall St
Syracuse, NY 13209-9606 - Phone
- (412) 848-5784
- NPI assigned
- Jun 23, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 023350 | NY | Primary |
Addresses
Primary practice location
304 Westfall St
Syracuse, NY 13209-9606
Mailing address
304 Westfall Street
Syracuse, NY 13209
Phone (412) 848-5784
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023350 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403481600000",
"number": "1487069191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 WESTFALL STREET",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "13209",
"telephone_number": "412-848-5784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 WESTFALL ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132099606",
"telephone_number": "412-848-5784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "DEIDRE",
"name_prefix": "Mrs.",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-23",
"last_updated": "2014-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "023350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.