Provider Demographics
NPI:1720884208
Name:OWENS, TERRANCE DARRELL
Entity type:Individual
Prefix:MR
First Name:TERRANCE
Middle Name:DARRELL
Last Name:OWENS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2070 HACKBERRY ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44301-2875
Mailing Address - Country:US
Mailing Address - Phone:216-333-4689
Mailing Address - Fax:
Practice Address - Street 1:1507 SAINT CLAIR AVE NE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-2003
Practice Address - Country:US
Practice Address - Phone:216-417-0047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator