Provider Demographics
NPI:1427923275
Name:OWENS, KRISTIN GAIL
Entity type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:GAIL
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 1:1401 MCGINNES RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1845
Mailing Address - Country:US
Mailing Address - Phone:443-239-5165
Mailing Address - Fax:
Practice Address - Street 1:239 OLD NORTH RD
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:DE
Practice Address - Zip Code:19934-1241
Practice Address - Country:US
Practice Address - Phone:302-697-2161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE245117103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty