Individual
MR. ROBERT DALE OWENS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
705 HARRISON ST, LA PORTE, IN 46350
(219) 229-0109
Mailing address
705 HARRISON ST, LA PORTE, IN 46350-3417
(219) 229-0109
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.130090
OH
Other
Enumeration date
03/08/2010
Last updated
10/01/2018
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