Provider Demographics
NPI:1023879509
Name:DOW, CHLOE GRACE
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:GRACE
Last Name:DOW
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 1:126 VANDERKEMP AVE
Mailing Address - Street 2:
Mailing Address - City:BARNEVELD
Mailing Address - State:NY
Mailing Address - Zip Code:13304-2427
Mailing Address - Country:US
Mailing Address - Phone:315-520-6371
Mailing Address - Fax:
Practice Address - Street 1:4820 W TAFT RD STE 202
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-2806
Practice Address - Country:US
Practice Address - Phone:315-552-0406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028377225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist