Provider Demographics
NPI:1194471995
Name:OWINGS, ANITA KAY
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:KAY
Last Name:OWINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1915
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:NM
Mailing Address - Zip Code:88231-1915
Mailing Address - Country:US
Mailing Address - Phone:575-441-5223
Mailing Address - Fax:
Practice Address - Street 1:1614 LEAVELL DR
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:NM
Practice Address - Zip Code:88231-3739
Practice Address - Country:US
Practice Address - Phone:575-441-5223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRBT-22-202319106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician