Provider Demographics
NPI:1912232448
Name:OWENS, CHRISTY DAWN (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:DAWN
Last Name:OWENS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 STONE HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-9066
Mailing Address - Country:US
Mailing Address - Phone:502-827-2385
Mailing Address - Fax:
Practice Address - Street 1:203 STONE HOUSE RD
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-9066
Practice Address - Country:US
Practice Address - Phone:502-827-2385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2292225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist