| Doctor Name: | BRENDA L OWEN |
| NPI Number: | 1346542727 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LAC, LICSW |
| License Number: | 1613 |
| Business Practice Address: | 224 4th St Nw Ste 5 Devils Lake, ND - 583012960 |
| Business Phone Number: | 7016626776 |
| Business Fax Number: | 7016626889 |
| Mailing Address: | 13580 59th St Nw, Lot K6 WILLISTON |
| State: | ND |
| Postal Code: | 588018938 |
| Phone Number: | 7016590490 |
| Fax Number: | 7016590490 |
| NPI Enumeration Date: | 11/17/2010 |
| NPI Last Update Date: | 04/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1613 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ND |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |