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NPI Code Detail

MEDICARE: JQUAN OWENS

MEDICARE:   JQUAN  OWENS
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
1103K00000XBehavior Analyst
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1760929343
Entity Type Code : Individual
Provider Name (Legal Business Name) : JQUAN OWENS
Provider Business Mailing Address
First Line : 3416 PALATINE HILLS AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89081-6540
Country : US
Telephone Number : 702-587-3723
Fax Number : 702-333-4480
Provider Business Practice Location Address
First Line : 3416 PALATINE HILLS AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89081-6540
Country : US
Telephone Number : 702-587-3723
Fax Number : 702-333-4480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2017
Last Update Date : 01/20/2017

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Directions to “ JQUAN OWENS ” Practice Location

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