Provider Demographics
NPI:1144480435
Name:GOWER, MADGE DUNMYER (MS CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:MADGE
Middle Name:DUNMYER
Last Name:GOWER
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6604 HIAWATHA DR NW
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35967-8268
Mailing Address - Country:US
Mailing Address - Phone:256-845-3072
Mailing Address - Fax:
Practice Address - Street 1:6604 HIAWATHA DR NW
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35967-8268
Practice Address - Country:US
Practice Address - Phone:256-845-3072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1305235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist