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General NPI Number Information
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NPI Number | 1154618494
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Entity Type | Individual
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Provider Name | LYNN LORIS OWENS PSYD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 07/14/2016
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Provider Practice Location Address
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Address Line | 10015 OLD COLUMBIA RD SUITE B-215
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City | COLUMBIA
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State | MD
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Zip | 21046-1703
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Country | US
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Telephone | 410-309-7055
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Fax | 410-290-5285
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Provider Business Mailing Address
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Address Line | 10015 OLD COLUMBIA RD STE B215
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City | COLUMBIA
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State | MD
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Zip | 21046-1865
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Country | US
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Telephone | 410-309-7055
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Fax | 410-290-5285
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 04825
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License Number State | MD
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