Individual
DESTINEE OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 SALEM ST, LAFAYETTE, IN 47904-2147
(765) 420-1400
Mailing address
2000 GREENBUSH ST, LAFAYETTE, IN 47904-2255
(765) 423-5531
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-440279
IN
Other
Enumeration date
07/08/2025
Last updated
07/08/2025
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