Individual
MISS JENNIFER OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6430 SAVANNAH AVE, PORTAGE, IN 46368-4534
(219) 617-6763
Mailing address
6430 SAVANNAH AVE, PORTAGE, IN 46368-4534
(219) 617-6763
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005113A
IN
Other
Enumeration date
04/03/2015
Last updated
04/03/2015
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