Provider Demographics
NPI:1588069090
Name:STOWELL, CONNIE (OTR/L)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:
Last Name:STOWELL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CONNIE
Other - Middle Name:
Other - Last Name:PREISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT/L
Mailing Address - Street 1:723 W FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:NE
Mailing Address - Zip Code:68620-1725
Mailing Address - Country:US
Mailing Address - Phone:402-395-3184
Mailing Address - Fax:402-395-3169
Practice Address - Street 1:723 W FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NE
Practice Address - Zip Code:68620-1725
Practice Address - Country:US
Practice Address - Phone:402-395-3184
Practice Address - Fax:402-395-3169
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1685225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist