Healthcare Provider Details

I. General information

NPI: 1861980716
Provider Name (Legal Business Name): OWLS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2776 S ARLINGTON MILL DR # 546
ARLINGTON VA
22206-3402
US

IV. Provider business mailing address

2776 S ARLINGTON MILL DR # 546
ARLINGTON VA
22206-3402
US

V. Phone/Fax

Practice location:
  • Phone: 858-699-5638
  • Fax:
Mailing address:
  • Phone: 858-699-5638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202006249
License Number StateVA

VIII. Authorized Official

Name: MRS. JANENE N BESCH
Title or Position: OWNER
Credential: MA, CCC-SLP
Phone: 858-699-5638