Provider Demographics
NPI:1508027053
Name:ROWELL, AMANDA MORGAN (OT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MORGAN
Last Name:ROWELL
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 1:21322 SHAWNEE PARK DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2992
Mailing Address - Country:US
Mailing Address - Phone:832-222-2195
Mailing Address - Fax:
Practice Address - Street 1:21322 SHAWNEE PARK DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-2992
Practice Address - Country:US
Practice Address - Phone:832-222-2195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110807225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist