Provider Demographics
NPI:1538451471
Name:OWEN, LURA JEAN (MAPM)
Entity type:Individual
Prefix:MS
First Name:LURA
Middle Name:JEAN
Last Name:OWEN
Suffix:
Gender:F
Credentials:MAPM
Other - Prefix:MS
Other - First Name:LURA
Other - Middle Name:JEAN
Other - Last Name:DAHLEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAPM
Mailing Address - Street 1:PO BOX 691
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73702-0691
Mailing Address - Country:US
Mailing Address - Phone:405-593-0702
Mailing Address - Fax:
Practice Address - Street 1:2615 E RANDOLPH AVE STE 114
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-4670
Practice Address - Country:US
Practice Address - Phone:405-593-0702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral