Individual
LARRY OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
93 WILLOWICK DR, LITHONIA, GA 30038-1700
(678) 361-7950
Mailing address
93 WILLOWICK DR, LITHONIA, GA 30038-1700
(678) 361-7950
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
Other
Enumeration date
10/19/2011
Last updated
10/06/2014
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