Provider Demographics
NPI:1619202454
Name:OWENS, GINA (PHD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 CIRCLE DR DEPT OF PSYCHOLOGY
Mailing Address - Street 2:UNIVERSITY OF TENNESSEE
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37996-0001
Mailing Address - Country:US
Mailing Address - Phone:865-974-2204
Mailing Address - Fax:865-974-3330
Practice Address - Street 1:1404 CIRCLE DR DEPT OF PSYCHOLOGY
Practice Address - Street 2:UNIVERSITY OF TENNESSEE
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37996-0001
Practice Address - Country:US
Practice Address - Phone:865-974-2204
Practice Address - Fax:865-974-3330
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2767103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling