Provider Demographics
NPI:1871769463
Name:OWENS, JENNIFER LAWLER (LPC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LAWLER
Last Name:OWENS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:440 RACETRACK RD
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-6837
Mailing Address - Country:US
Mailing Address - Phone:770-288-7591
Mailing Address - Fax:770-288-7594
Practice Address - Street 1:440 RACETRACK RD
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-6837
Practice Address - Country:US
Practice Address - Phone:770-288-7591
Practice Address - Fax:770-288-7594
Is Sole Proprietor?:No
Enumeration Date:2008-05-02
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005133101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional