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Individual

MRS. LAURA MAE OWEN-KEIRSTEAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1670 E 1475 S, OGDEN, UT 84404-6009
(801) 394-4547
Mailing address
1670 E 1475 S, OGDEN, UT 84404-6009
(801) 394-4547

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
136614-6004
UT
104100000X
Social Worker
136614-3503
UT

Other

Enumeration date
07/20/2011
Last updated
07/20/2011
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