Provider Demographics
NPI:1093272643
Name:OWENS, SHAWNDRA (DODD)
Entity Type:Individual
Prefix:
First Name:SHAWNDRA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:DODD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 W SYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-4639
Mailing Address - Country:US
Mailing Address - Phone:419-490-5200
Mailing Address - Fax:
Practice Address - Street 1:1812 W SYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-4639
Practice Address - Country:US
Practice Address - Phone:419-490-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-01
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator