Provider Demographics
NPI:1083064018
Name:OWENS, JASMINE (MS, NCC)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 3RD ST NW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4094
Mailing Address - Country:US
Mailing Address - Phone:863-229-5219
Mailing Address - Fax:
Practice Address - Street 1:371 AUDUBON OAKS DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-5932
Practice Address - Country:US
Practice Address - Phone:610-809-4972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health