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General NPI Number Information
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NPI Number | 1760910285
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Entity Type | Individual
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Provider Name | ARCHANDRIA COLETTE OWENS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/28/2017
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Last Update Date | 05/28/2017
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Provider Practice Location Address
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Address Line | 1340 PRUDENTIAL DR
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City | DALLAS
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State | TX
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Zip | 75235-4115
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Country | US
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Telephone | 901-651-7557
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Fax |
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Provider Business Mailing Address
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Address Line | 1715 STONECREST TRL
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City | WYLIE
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State | TX
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Zip | 75098-7758
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Country | US
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Telephone | 901-651-7557
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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 | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 37505
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License Number State | TX
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