Provider Demographics
NPI:1619294493
Name:BOWES, JESSICA R (OTR/L)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:R
Last Name:BOWES
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 1:145 STEFFEE BLVD.
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:PA
Mailing Address - Zip Code:16346
Mailing Address - Country:US
Mailing Address - Phone:814-677-1390
Mailing Address - Fax:814-677-1393
Practice Address - Street 1:145 STEFFEE BLVD.
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346
Practice Address - Country:US
Practice Address - Phone:814-677-1390
Practice Address - Fax:814-677-1393
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011342225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist