Provider Demographics
NPI:1861100398
Name:OWENS, KIARA (MA, LMFT)
Entity type:Individual
Prefix:MRS
First Name:KIARA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 XENIUM LN N APT 102
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-2222
Mailing Address - Country:US
Mailing Address - Phone:763-742-5980
Mailing Address - Fax:
Practice Address - Street 1:5901 BROOKLYN BLVD STE 201
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-2533
Practice Address - Country:US
Practice Address - Phone:763-732-2320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
0OtherN/A