Individual
JANA N/A OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 6TH AVE W, HUNTINGTON, WV 25701-0028
(304) 525-8014
Mailing address
3604 BRANDON RD, HUNTINGTON, WV 25704-1106
(859) 638-2830
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-64317
WV
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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