Individual
DEAN R OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICDC
Contact information
Practice address
8402 BLACKJACK ROAD EXT, MOUNT VERNON, OH 43050-9193
(740) 522-8477
(740) 788-3424
Mailing address
PO BOX 4670, NEWARK, OH 43058-4670
(740) 522-8477
(740) 788-3424
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC 933671-CS
OH
104100000X
Social Worker
Primary
S.0013531
OH
Other
Enumeration date
02/12/2013
Last updated
09/16/2016
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