Basic Information
Provider Information
NPI: 1831494244
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GILMAN-OWENS
FirstName: JANCLAUDETTE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PSY.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1430 WILKINS CIRCLE
Address2:  
City: CASPER
State: WY
PostalCode: 826011336
CountryCode: US
TelephoneNumber: 3072379583
FaxNumber: 3072657277
Practice Location
Address1: 1430 WILKINS CIRCLE
Address2:  
City: CASPER
State: WY
PostalCode: 826011336
CountryCode: US
TelephoneNumber: 3072379583
FaxNumber: 3072657277
Other Information
ProviderEnumerationDate: 01/14/2011
LastUpdateDate: 01/14/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700XPSB34475CAN Behavioral Health & Social Service ProvidersPsychologistClinical
101Y00000XPSB34475CAY Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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