Provider Demographics
NPI:1396877460
Name:ROWLEY, ABBEY (MBS)
Entity type:Individual
Prefix:
First Name:ABBEY
Middle Name:
Last Name:ROWLEY
Suffix:
Gender:F
Credentials:MBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5419 ROADRUNNER DR
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-2452
Mailing Address - Country:US
Mailing Address - Phone:580-775-1680
Mailing Address - Fax:580-924-4779
Practice Address - Street 1:114 S 7TH AVE
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-5017
Practice Address - Country:US
Practice Address - Phone:580-775-1680
Practice Address - Fax:580-924-4779
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200344420AMedicaid