Provider Demographics
NPI:1164602140
Name:ROWE, GRETCHEN A (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:GRETCHEN
Middle Name:A
Last Name:ROWE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 W CENTRAL ST
Mailing Address - Street 2:SUITE 22
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-3758
Mailing Address - Country:US
Mailing Address - Phone:508-655-5222
Mailing Address - Fax:
Practice Address - Street 1:251 W CENTRAL ST
Practice Address - Street 2:SUITE 22
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-3758
Practice Address - Country:US
Practice Address - Phone:508-655-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8266171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator