Individual
THASIHA OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
497 ROCKAWAY AVE, VALLEY STREAM, NY 11581-1909
(718) 327-7002
Mailing address
497 ROCKAWAY AVE, VALLEY STREAM, NY 11581-1909
(718) 845-2621
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
175T00000X
NY
Other
Enumeration date
01/15/2021
Last updated
01/15/2021
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