Individual
ANGELA MICHELLE OWEN-KILLAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
236 LE PHILLIP CT, SUITE D, CONCORD, NC 28025-1905
(704) 786-4503
Mailing address
236 LE PHILLIP CT NE STE D, CONCORD, NC 28025-1917
(704) 652-1188
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2091
NC
103TC0700X
Clinical Psychologist
2091
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046JX
BCBS PROVIDER NUMBER
NC
Enumeration date
11/10/2006
Last updated
10/05/2021
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