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General NPI Number Information
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NPI Number | 1275534505
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Entity Type | Individual
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Provider Name | JULIEANNA BOWEN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 10567 165TH ST W STE 260
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City | LAKEVILLE
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State | MN
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Zip | 55044-3524
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Country | US
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Telephone | 527-679-3749
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Fax | 855-538-0663
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Provider Business Mailing Address
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Address Line | 10567 165TH ST W
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City | LAKEVILLE
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State | MN
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Zip | 55044-3523
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Country | US
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Telephone | 952-767-9374
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Fax | 855-538-0663
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 103171
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6908
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License Number State | MN
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