Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003075169 |
---|---|
Provider Name | Mrs. Ericka Lynn Owens |
First Address | Providence, RI 02903-1559 |
Second Address | Taunton, MA 02780-3960 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2008 |
Last Update Date | 04/06/2008 |