Provider Demographics
NPI:1003211285
Name:AUEN, COLLEEN MICHELLE (OTD)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:MICHELLE
Last Name:AUEN
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:MICHELLE
Other - Last Name:FOWLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD
Mailing Address - Street 1:3092 OTTER AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE VIEW
Mailing Address - State:IA
Mailing Address - Zip Code:51450-7420
Mailing Address - Country:US
Mailing Address - Phone:319-361-7176
Mailing Address - Fax:
Practice Address - Street 1:415 W HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:NEWELL
Practice Address - State:IA
Practice Address - Zip Code:50568-5065
Practice Address - Country:US
Practice Address - Phone:712-272-3327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002296225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist