Individual
REGINALD OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8555 TAFT ST, MERRILLVILLE, IN 46410-6123
(219) 769-4005
Mailing address
8400 LOUISIANA ST, MERRILLVILLE, IN 46410-6385
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39003817A
IN
Other
Enumeration date
11/14/2020
Last updated
11/14/2020
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