Individual
ANTONIO OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
424 S 47TH WEST AVE, TULSA, OK 74127-7607
(918) 991-4825
Mailing address
424 S 47TH WEST AVE, TULSA, OK 74127-7607
(918) 991-4825
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10495
OK
374K00000X
Religious Nonmedical Practitioner
70453
OK
Other
Enumeration date
05/05/2019
Last updated
04/22/2024
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