Provider Demographics
NPI:1205888666
Name:STOWELL, MARCIA W (MA FAAA)
Entity type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:W
Last Name:STOWELL
Suffix:
Gender:F
Credentials:MA FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WAITE ST
Mailing Address - Street 2:SUITE B-2
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-3200
Mailing Address - Country:US
Mailing Address - Phone:864-509-1152
Mailing Address - Fax:864-509-1154
Practice Address - Street 1:12 WAITE ST
Practice Address - Street 2:SUITE B-2
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3200
Practice Address - Country:US
Practice Address - Phone:864-509-1152
Practice Address - Fax:864-509-1154
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC511231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP5581Medicaid
SCQ32460Medicare UPIN