Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 156 | KS |
Y | 103T00000X | Psychologist | 156 | KS |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | LCAC99 | KS |
NPI | 1396213377 |
---|---|
Provider Name | Ms. Ruth N Owens-Jurgens |
First Address | Topeka, KS 66604 |
Second Address | Topeka, KS 66604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2018 |
Last Update Date | 07/11/2018 |