Provider Demographics
NPI:1215683875
Name:OWEN, JANEEN MARIE (SLP MA/CCC8645)
Entity type:Individual
Prefix:MRS
First Name:JANEEN
Middle Name:MARIE
Last Name:OWEN
Suffix:
Gender:F
Credentials:SLP MA/CCC8645
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3732 EARLY DAWN DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-7359
Mailing Address - Country:US
Mailing Address - Phone:209-402-5954
Mailing Address - Fax:
Practice Address - Street 1:3732 EARLY DAWN DR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-7359
Practice Address - Country:US
Practice Address - Phone:209-402-5954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8645235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist