Provider Information for 1356693584
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JESSICA PHIPPS OWEN M.S., LCASA, LPCA
Sex: Female
NPI: 1356693584
Last Updated: 2015-07-01
Certification Date:
Certification Date:
Details
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NPI | 1356693584 | ||||||||
Enumeration Date | 2012-10-11 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 110 N EASTERN ST GREENVILLE, NC 27858-2137 United States Phone: 336-682-1159 | Fax: | ||||||||
Primary Practice Address | 1401 PARK AVE NEW BERN, NC 28560-5502 United States Phone: 252-636-3381 | Fax: | ||||||||
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