Provider Demographics
NPI:1649846916
Name:OWUSU, JUANITA MICHELLE
Entity type:Individual
Prefix:MRS
First Name:JUANITA
Middle Name:MICHELLE
Last Name:OWUSU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JUANITA
Other - Middle Name:M
Other - Last Name:OWUSU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, MED, BCBA
Mailing Address - Street 1:6 AUTUMNWOOD CT
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-1905
Mailing Address - Country:US
Mailing Address - Phone:302-760-3334
Mailing Address - Fax:
Practice Address - Street 1:6 AUTUMNWOOD CT
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-1905
Practice Address - Country:US
Practice Address - Phone:302-760-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-50146103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst