Provider Demographics
NPI:1295408979
Name:LOWMAN, JESSICA RUTH (OT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:RUTH
Last Name:LOWMAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 EDINBURGH LN
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-1091
Mailing Address - Country:US
Mailing Address - Phone:757-951-8793
Mailing Address - Fax:
Practice Address - Street 1:2000 WILKES RIDGE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-7632
Practice Address - Country:US
Practice Address - Phone:804-877-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119008272225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation