NPI 1457083057

Kelvin Lamar Owens

Practitioner Peer Specialist Phoenix, AZ

Practice location

Address: 5501 N 19th Ave STE 215, Phoenix, AZ 85015-2450
Phone: (480) 409-0963

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X

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Registry record

NPI: 1457083057
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Jun 2022
Record last updated: 30 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.