Provider Demographics
NPI:1699966069
Name:OWSLEY, JEAN (OTRL)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:OWSLEY
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MISS
Other - First Name:JEAN
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1219 JOHNSON STREET
Mailing Address - Street 2:
Mailing Address - City:THERMOPOLIS
Mailing Address - State:WY
Mailing Address - Zip Code:82443
Mailing Address - Country:US
Mailing Address - Phone:307-921-9928
Mailing Address - Fax:
Practice Address - Street 1:5901 BROKEN SOUND PARKWAY NW
Practice Address - Street 2:SUITE 500
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487
Practice Address - Country:US
Practice Address - Phone:800-875-8999
Practice Address - Fax:561-367-0884
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT8332225X00000X
WYOTR346225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist