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General NPI Number Information
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NPI Number | 1902719743
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Entity Type | Individual
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Provider Name | CELITA OWENS
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Gender | Female
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 59 GENERAL WARREN BLVD
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City | MALVERN
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State | PA
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Zip | 19355-1245
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Country | US
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Telephone | 484-870-5608
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Fax |
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Provider Business Mailing Address
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Address Line | 2227 N 33RD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19132-2802
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Country | US
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Telephone |
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PS020873
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS020873
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License Number State | PA
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