Provider Demographics
NPI:1720874761
Name:OWENS, MAYA (MED)
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:OWENS
Suffix:
Gender:
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5520 MAYFAIR CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-1181
Mailing Address - Country:US
Mailing Address - Phone:404-834-3193
Mailing Address - Fax:
Practice Address - Street 1:5520 MAYFAIR CROSSING DR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-1181
Practice Address - Country:US
Practice Address - Phone:404-834-3193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor