Provider Demographics
NPI:1982935383
Name:OWENS, TERESA (MA, ATR-BC, CGP)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:MA, ATR-BC, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 BEECHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-2307
Mailing Address - Country:US
Mailing Address - Phone:973-865-7772
Mailing Address - Fax:
Practice Address - Street 1:405 BEECHWOOD RD
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2307
Practice Address - Country:US
Practice Address - Phone:973-865-7772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist