Healthcare Provider Details

I. General information

NPI: 1083513402
Provider Name (Legal Business Name): BRANDI L OWENS LMBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2026
Last Update Date: 11/03/2026
Certification Date: 11/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1506 E RUTHERFORD ST STE B
LANDRUM SC
29356-1400
US

IV. Provider business mailing address

4180 LANDRUM RD
COLUMBUS NC
28722-4434
US

V. Phone/Fax

Practice location:
  • Phone: 828-899-1080
  • Fax:
Mailing address:
  • Phone: 864-510-8597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number22796
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number13328
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: