Provider Demographics
NPI:1821860198
Name:ROWE, ISLEY ADDISON
Entity Type:Individual
Prefix:MS
First Name:ISLEY
Middle Name:ADDISON
Last Name:ROWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3144 OLD FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-1578
Mailing Address - Country:US
Mailing Address - Phone:817-965-2771
Mailing Address - Fax:
Practice Address - Street 1:3326 ASPEN GROVE DR STE 604
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-4858
Practice Address - Country:US
Practice Address - Phone:629-236-4547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician