Individual
SHANDA RENEE OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3524 83RD ST, JACKSON HEIGHTS, NY 11372-5229
(718) 639-0700
(718) 639-7684
Mailing address
46 GOSHEN ST, ELMONT, NY 11003-5025
(718) 639-0700
(718) 639-7684
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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