Healthcare Provider Details

I. General information

NPI: 1518559715
Provider Name (Legal Business Name): KRISTINE V OWEN I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2021
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E LOUTHER ST BLDG 2
CARLISLE PA
17013-2657
US

IV. Provider business mailing address

401 E LOUTHER ST BLDG 2
CARLISLE PA
17013-2657
US

V. Phone/Fax

Practice location:
  • Phone: 717-744-9933
  • Fax:
Mailing address:
  • Phone: 717-744-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC020690
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: