Provider Demographics
NPI:1861932303
Name:OWEN, ARIEL (OTR/L)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:OWEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3626 GRANT LINE RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-2298
Mailing Address - Country:US
Mailing Address - Phone:812-944-1377
Mailing Address - Fax:812-944-1458
Practice Address - Street 1:3626 GRANT LINE RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2298
Practice Address - Country:US
Practice Address - Phone:812-944-1377
Practice Address - Fax:812-944-1458
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31005489A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist