Provider Demographics
NPI:1124748801
Name:OWEN, ANN GIOVANNETTI (OTR)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:GIOVANNETTI
Last Name:OWEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9065 GOLD RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-5821
Mailing Address - Country:US
Mailing Address - Phone:804-221-5099
Mailing Address - Fax:
Practice Address - Street 1:1257 MARYWOOD LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-6059
Practice Address - Country:US
Practice Address - Phone:804-741-8624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119002990225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist