Healthcare Provider Details

I. General information

NPI: 1386749273
Provider Name (Legal Business Name): KATHARINE KAY OWENS ED.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 DEFENSE HWY SUITE 107
ANNAPOLIS MD
21401-7098
US

IV. Provider business mailing address

133 DEFENSE HWY SUITE 107
ANNAPOLIS MD
21401-7098
US

V. Phone/Fax

Practice location:
  • Phone: 410-224-2021
  • Fax: 410-224-2420
Mailing address:
  • Phone: 410-224-2021
  • Fax: 410-224-2420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number01436
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: