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Individual

MISS JORDAN JANE BOWMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA CCC-SLP

Contact information

Practice address
5905 W WASHINGTON BLVD, GENESIS REHAB-MAYFIELD CARE CENTRE, CHICAGO, IL 60644-2845
(773) 261-7074
Mailing address
1102 WEST AVE, APARTMENT 3, RICHMOND, VA 23220-3725
(614) 370-7395

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2202005463
VA
235Z00000X
Speech-Language Pathologist
Primary
2202005863
VA

Other

Enumeration date
08/03/2011
Last updated
03/29/2012
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