Basic Information
| Provider Information | |||||||||
| NPI: | 1003571092 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OWUSU | ||||||||
| FirstName: | DOCIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CRMP-PMH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13842 OUTLET DR # 214 | ||||||||
| Address2: | |||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209044931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014485634 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7575 E HOWARD RD | ||||||||
| Address2: | |||||||||
| City: | GLEN BURNIE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210608312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107688200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2021 | ||||||||
| LastUpdateDate: | 04/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | R220828 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.