Provider Demographics
NPI:1710255955
Name:OWENS, TIMOTHY LEWIS (MS)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:LEWIS
Last Name:OWENS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 N PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74106-2512
Mailing Address - Country:US
Mailing Address - Phone:918-794-0197
Mailing Address - Fax:
Practice Address - Street 1:2625 N PEORIA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-2512
Practice Address - Country:US
Practice Address - Phone:918-794-0197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health