Provider Demographics
NPI:1851628424
Name:OWENS, MURRY STEEN
Entity Type:Individual
Prefix:
First Name:MURRY
Middle Name:STEEN
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 1:3163 N RAVEN LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-6513
Mailing Address - Country:US
Mailing Address - Phone:501-258-3466
Mailing Address - Fax:
Practice Address - Street 1:5305 W VILLAGE PKWY
Practice Address - Street 2:SUITE 9
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8102
Practice Address - Country:US
Practice Address - Phone:501-258-3466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP8275235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR178304721Medicaid