Provider Demographics
NPI:1689205197
Name:OWENS, TALYN KIARA
Entity Type:Individual
Prefix:
First Name:TALYN
Middle Name:KIARA
Last Name:OWENS
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 1:2745 CROSSHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-7406
Mailing Address - Country:US
Mailing Address - Phone:706-218-6109
Mailing Address - Fax:
Practice Address - Street 1:2745 CROSSHAVEN DR
Practice Address - Street 2:
Practice Address - City:HEPHZIBAH
Practice Address - State:GA
Practice Address - Zip Code:30815-7406
Practice Address - Country:US
Practice Address - Phone:706-218-6109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician