Individual
MR. CAMRON TYLER OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
801 E MAIN ST, TISHOMINGO, OK 73460-2351
(580) 371-3799
(580) 371-2056
Mailing address
1307 S JOHNSTON ST, ADA, OK 74820-8149
(580) 421-6980
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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