Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1245501022 |
---|---|
Provider Name | Terry L Owens |
First Address | Oklahoma City, OK 73104-4209 |
Second Address | Hollis, OK 73550-4202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2012 |
Last Update Date | 12/09/2012 |