Healthcare Provider Details

I. General information

NPI: 1487837092
Provider Name (Legal Business Name): JANICE LUCILLE OWNBY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2007
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 SE 4TH ST
TOPEKA KS
66603-3504
US

IV. Provider business mailing address

217 SE 4TH ST
TOPEKA KS
66603-3504
US

V. Phone/Fax

Practice location:
  • Phone: 785-266-4859
  • Fax:
Mailing address:
  • Phone: 785-266-4859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6454
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: