Provider Demographics
NPI:1457798431
Name:MCGOWAN, TERRY (OT)
Entity type:Individual
Prefix:MS
First Name:TERRY
Middle Name:
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:IRENE
Other - Middle Name:
Other - Last Name:MCGOWAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:25 YARMOUTH CT
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-3159
Mailing Address - Country:US
Mailing Address - Phone:908-612-7338
Mailing Address - Fax:
Practice Address - Street 1:25 YARMOUTH CT
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-3159
Practice Address - Country:US
Practice Address - Phone:908-612-7338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007483225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist