Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PY60865383 | WA |
N | 103T00000X | Psychologist | PY60865383 | WA |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 20043391A | IN |
NPI | 1134583750 |
---|---|
Provider Name | Michele Shyuan Tsai Owens |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Seattle, WA 98105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2016 |
Last Update Date | 12/10/2020 |