Healthcare Provider Details

I. General information

NPI: 1679491229
Provider Name (Legal Business Name): GLORIA RENEE MARIE COWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 DRYDEN DR
TOLEDO OH
43612-1827
US

IV. Provider business mailing address

906 DRYDEN DR
TOLEDO OH
43612-1827
US

V. Phone/Fax

Practice location:
  • Phone: 907-201-2168
  • Fax:
Mailing address:
  • Phone: 907-201-2168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: