Provider Demographics
NPI:1821701038
Name:OWENS, SYMPHANI NOWELL
Entity Type:Individual
Prefix:
First Name:SYMPHANI
Middle Name:NOWELL
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 1:7644 NORTHPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6641
Mailing Address - Country:US
Mailing Address - Phone:850-206-8998
Mailing Address - Fax:
Practice Address - Street 1:7644 NORTHPOINTE DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-6641
Practice Address - Country:US
Practice Address - Phone:850-206-8998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist