Individual
DEVOUGHN T. OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23580 MEADOWLARK ST, OAK PARK, MI 48237-2275
(248) 545-0133
(248) 864-8724
Mailing address
23580 MEADOWLARK ST, OAK PARK, MI 48237-2275
(248) 545-0133
(248) 864-8724
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704188778
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AS630247107
ADULT FOSTER CARE PROVIDER FOR THE MENTALLY ILL AND DEVELOPMENTALLY DISABLED
MI
Enumeration date
05/11/2017
Last updated
04/02/2018
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