Provider Demographics
NPI:1386749273
Name:OWENS, KATHARINE KAY (EDD)
Entity type:Individual
Prefix:DR
First Name:KATHARINE
Middle Name:KAY
Last Name:OWENS
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 DEFENSE HWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7098
Mailing Address - Country:US
Mailing Address - Phone:410-224-2021
Mailing Address - Fax:410-224-2420
Practice Address - Street 1:133 DEFENSE HWY
Practice Address - Street 2:SUITE 107
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7098
Practice Address - Country:US
Practice Address - Phone:410-224-2021
Practice Address - Fax:410-224-2420
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01436103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH402 001OtherBXBS/FEP
MDGP71KKOtherBXBS/PPO MM
MD446RMedicare ID - Type Unspecified
MDGP71KKOtherBXBS/PPO MM
MD446RMedicare UPIN