Provider Demographics
NPI:1366827149
Name:OWENS, WENDY JILL
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:JILL
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 1:201 CONVERSE RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-1703
Mailing Address - Country:US
Mailing Address - Phone:203-952-4082
Mailing Address - Fax:
Practice Address - Street 1:201 CONVERSE RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738-1703
Practice Address - Country:US
Practice Address - Phone:203-952-4082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health