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NPI 1356812341

NPI 1356812341 : JANA N/A OWENS : HUNTINGTON, WV

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General NPI Number Information
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    NPI Number           |    1356812341
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    Entity Type          |    Individual 
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    Provider Name        |    JANA N/A OWENS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/17/2018
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    Last Update Date     |    12/17/2018
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Provider Practice Location Address
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    Address Line         |    10 6TH AVE W 
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    City                 |    HUNTINGTON
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    State                |    WV
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    Zip                  |    25701-0028
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    Country              |    US
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    Telephone            |    304-525-8014
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3604 BRANDON RD 
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    City                 |    HUNTINGTON
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    State                |    WV
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    Zip                  |    25704-1106
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    Country              |    US
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    Telephone            |    859-638-2830
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    Fax                  |    
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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        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    RBT-18-64317
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    License Number State |    WV
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