Individual
MARY J OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 WASHINGTON ST, ELMIRA, NY 14901-2849
(607) 737-4892
(607) 737-9080
Mailing address
100 WASHINGTON ST, ELMIRA, NY 14901-2849
(607) 737-4892
(607) 737-9080
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
456288
NY
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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