Individual
ETHAN OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
146 2ND ST N STE 101, ST PETERSBURG, FL 33701-3361
(727) 490-9911
Mailing address
146 2ND ST N STE 101, ST PETERSBURG, FL 33701-3361
(727) 490-9911
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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