Individual
MATTIE 'RANDI' MAE OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED, CADC-I, LPC
Contact information
Practice address
491 N KNIK ST, WASILLA, AK 99654-7049
(907) 376-9500
(907) 373-2175
Mailing address
500 W SCHEELITE DR, P.O. BOX 871508, WASILLA, AK 99654-1304
(907) 373-2175
(907) 373-2175
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0046
AK
Other
Enumeration date
12/26/2007
Last updated
12/26/2007
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