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General NPI Number Information
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NPI Number | 1114658549
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Entity Type | Organization
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Legal Business Name | OWEN CLINIC
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 12901 E BRITTON RD STE B
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City | JONES
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State | OK
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Zip | 73049-7407
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Country | US
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Telephone | 405-740-1249
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Fax | 405-399-2471
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Provider Business Mailing Address
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Address Line | 12901 E BRITTON RD STE B
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City | JONES
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State | OK
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Zip | 73049-7407
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Country | US
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Telephone | 405-740-1249
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Fax | 405-399-2471
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Authorized Official
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Title or Position | CLINICAL DIRECTOR, CLINICIAN
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Name | DR. KEVON OWEN
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Credential | DCOUN
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Telephone | 405-740-1249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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