Provider Demographics
NPI:1528484169
Name:ROWAN, ALYSSA (MS, OTR-L)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:ROWAN
Suffix:
Gender:F
Credentials:MS, OTR-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WALKER AVE
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4023
Mailing Address - Country:US
Mailing Address - Phone:410-358-1997
Mailing Address - Fax:866-840-6040
Practice Address - Street 1:15 WALKER AVE
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4023
Practice Address - Country:US
Practice Address - Phone:410-358-1997
Practice Address - Fax:866-840-6040
Is Sole Proprietor?:No
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07202222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist