Provider Demographics
NPI:1255665998
Name:BOWEN, ANNE (COTA)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:BOWEN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12999 N. PENNSYLVANIA AVE.
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032
Mailing Address - Country:US
Mailing Address - Phone:317-848-2448
Mailing Address - Fax:317-848-1535
Practice Address - Street 1:12999 N. PENNSYLVANIA AVE.
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032
Practice Address - Country:US
Practice Address - Phone:317-848-2448
Practice Address - Fax:317-848-1535
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32000762A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant