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NPI Code Detail

MEDICARE: KYMBERLY J OWENS MSW

MEDICARE: KYMBERLY J OWENS MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker209CO

General Provider Information

NPI Number : 1336367838
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYMBERLY J OWENS MSW
Provider Business Mailing Address
First Line : PO BOX 70
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81502-0070
Country : US
Telephone Number : 970-858-1441
Fax Number :
Provider Business Practice Location Address
First Line : 1170 COLORADO AVE
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81501-3523
Country : US
Telephone Number : 970-250-6270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 07/08/2007

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