Individual
OLIVIA OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
3825 39TH AVE STE 120, KENOSHA, WI 53144-2043
(262) 946-5752
Mailing address
3825 39TH AVE STE 120, KENOSHA, WI 53144-2043
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20488
WI
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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