Individual
XIOMARA CRESENSIA OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
829 CHIEF EDDIE HOFFMAN HWY, BETHEL, AK 99559
(907) 543-6100
(907) 543-6008
Mailing address
PO BOX 528, BETHEL, AK 99559
(907) 543-6100
(907) 543-6008
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH0150
—
AK
Enumeration date
08/28/2012
Last updated
09/19/2012
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