Provider Demographics
NPI:1235790346
Name:OWENS, DONNA L (CPRS)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:OWENS
Suffix:
Gender:F
Credentials:CPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 SAINT FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-3413
Mailing Address - Country:US
Mailing Address - Phone:567-220-7018
Mailing Address - Fax:
Practice Address - Street 1:65 SAINT FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-3413
Practice Address - Country:US
Practice Address - Phone:567-220-7018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH902175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist