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General NPI Number Information
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NPI Number | 1770906158
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Entity Type | Organization
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Legal Business Name | NNEKA J. OWENS LLC
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Dates
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Enumeration Date | 01/21/2014
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Last Update Date | 10/06/2015
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Provider Practice Location Address
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Address Line | 22190 GARRISON ST STE 204
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City | DEARBORN
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State | MI
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Zip | 48124-2260
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Country | US
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Telephone | 313-769-5705
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Fax | 313-769-6008
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Provider Business Mailing Address
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Address Line | 22190 GARRISON ST STE 204
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City | DEARBORN
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State | MI
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Zip | 48124-2260
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Country | US
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Telephone | 313-769-5705
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Fax | 313-769-6008
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Authorized Official
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Title or Position | LPC NCC - DIRECTOR
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Name | MRS. NNEKA JEAN OWENS
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Credential |
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Telephone | 313-769-5705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401009269
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License Number State | MI
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