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General NPI Number Information
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NPI Number | 1548520745
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Entity Type | Individual
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Provider Name | BRENDA EARL OWENSBY PHD
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Gender | Female
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Dates
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Enumeration Date | 05/22/2012
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Last Update Date | 05/22/2012
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Provider Practice Location Address
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Address Line | 109 STEKOIA LN
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City | KNOXVILLE
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State | TN
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Zip | 37912-1608
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Country | US
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Telephone | 865-296-2070
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Fax |
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Provider Business Mailing Address
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Address Line | 12201 E DONCASTER DR
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City | KNOXVILLE
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State | TN
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Zip | 37932-2844
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Country | US
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Telephone | 865-405-2704
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1276
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 1276
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License Number State | TN
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