Individual
MISS JACQUELYN DENISE OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, CNS/PMH-BC
Contact information
Practice address
3188 ATLANTA RD SE, SMYRNA, GA 30080-8256
(770) 319-6000
Mailing address
3263 BOULDER BROOK DR, LITHONIA, GA 30038-3004
(770) 482-7184
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN115796
GA
Other
Enumeration date
05/02/2007
Last updated
11/02/2011
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