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NPI Code Detail

MEDICARE: KRISTEN E OWENS MA,LPC

MEDICARE: KRISTEN E OWENS MA,LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor3527WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13527OTHERWISTATE LICENSE NUMBER

General Provider Information

NPI Number : 1093744666
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN E OWENS MA,LPC
Provider Business Mailing Address
First Line : PO BOX 8003
Second Line :
City : APPLETON
State : WI
Zip : 54912-8003
Country : US
Telephone Number : 920-996-3298
Fax Number : 920-738-5787
Provider Business Practice Location Address
First Line : 1095 MIDWAY RD
Second Line :
City : MENASHA
State : WI
Zip : 54952-1115
Country : US
Telephone Number : 920-720-2300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 07/08/2007

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Directions to “ KRISTEN E OWENS MA,LPC” Practice Location

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