Provider Demographics
NPI:1336945559
Name:FOWLER, AVA REESE (OTR)
Entity type:Individual
Prefix:
First Name:AVA
Middle Name:REESE
Last Name:FOWLER
Suffix:
Gender:
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 BELDEN AVE UNIT 1235
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3365
Mailing Address - Country:US
Mailing Address - Phone:610-551-2938
Mailing Address - Fax:
Practice Address - Street 1:38A GROVE ST STE 301
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4664
Practice Address - Country:US
Practice Address - Phone:203-881-6339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist