Provider Demographics
NPI:1316477862
Name:OWENS, JENNY LOU (PSYD)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:LOU
Last Name:OWENS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 OLD HICKORY BLVD APT 1517
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-5197
Mailing Address - Country:US
Mailing Address - Phone:270-903-9387
Mailing Address - Fax:
Practice Address - Street 1:1500 21ST AVE S STE 2200
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3137
Practice Address - Country:US
Practice Address - Phone:615-322-8701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN4085103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program