Provider Demographics
NPI:1144560939
Name:OWEN, AMI LAURA (LMFT)
Entity type:Individual
Prefix:DR
First Name:AMI
Middle Name:LAURA
Last Name:OWEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10513 W POPPY STREET
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-6807
Mailing Address - Country:US
Mailing Address - Phone:208-740-0544
Mailing Address - Fax:
Practice Address - Street 1:2121 N GARNET CREEK AVE
Practice Address - Street 2:
Practice Address - City:STAR
Practice Address - State:ID
Practice Address - Zip Code:83669-8001
Practice Address - Country:US
Practice Address - Phone:208-740-0544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMFT-5784106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist