Provider Demographics
NPI:1245501022
Name:OWENS, TERRY L (MBA)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:L
Last Name:OWENS
Suffix:
Gender:M
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 E SHERIDAN AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-4209
Mailing Address - Country:US
Mailing Address - Phone:405-200-0131
Mailing Address - Fax:405-270-0543
Practice Address - Street 1:120 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:OK
Practice Address - Zip Code:73550-4202
Practice Address - Country:US
Practice Address - Phone:580-688-9281
Practice Address - Fax:580-688-2669
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral