Individual
LAURA L OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1140 MULBERRY DR, TAHLEQUAH, OK 74464
(918) 453-1108
Mailing address
1245 CAMELOT DR APT B, TAHLEQUAH, OK 74464-4746
(918) 316-1381
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1869
GA
101YP2500X
Professional Counselor
Primary
4116
OK
Other
Enumeration date
03/20/2009
Last updated
03/12/2010
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