Provider Demographics
NPI:1245358209
Name:BOWEN, DAWN IRENE (OTR L CHT)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:IRENE
Last Name:BOWEN
Suffix:
Gender:F
Credentials:OTR L CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 SPRING ST NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3821
Mailing Address - Country:US
Mailing Address - Phone:404-872-4263
Mailing Address - Fax:
Practice Address - Street 1:955 SPRING ST NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3821
Practice Address - Country:US
Practice Address - Phone:404-872-4263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT002100225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand