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General NPI Number Information
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NPI Number | 1093680332
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Entity Type | Individual
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Provider Name | EMMALINE OWEN
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Gender | Female
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Dates
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Enumeration Date | 10/07/2025
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 701 S 3RD ST
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City | ODESSA
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State | MO
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Zip | 64076-1453
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Country | US
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Telephone | 816-633-5316
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Fax |
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Provider Business Mailing Address
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Address Line | 30882 HIGHWAY NN
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City | BLACKBURN
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State | MO
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Zip | 65321-2007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 2025040842
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License Number State | MO
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