Individual
MRS. SANDRA J OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW,PIP
Contact information
Practice address
18 W 11TH ST, ANNISTON, AL 36201-4585
(256) 312-5443
(256) 835-7927
Mailing address
PO BOX 1207, JACKSONVILLE, AL 36265-5207
(256) 312-5443
(256) 835-7927
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1440C
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09908
BCBS PROVIDER NUMBER
AL
01
—
11129
BC FEDERAL PROVIDER NUM
AL
Enumeration date
11/21/2006
Last updated
07/09/2007
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