Doctor Name: | SUSAN POWELL |
NPI Number: | 1144570151 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MED |
License Number: | |
Business Practice Address: | 42012 Timber Ridge Rd Howe, OK - 749403612 |
Business Phone Number: | 9186533135 |
Business Fax Number: | 9186472181 |
Mailing Address: | 42012 Timber Ridge Rd, HOWE |
State: | OK |
Postal Code: | 749403612 |
Phone Number: | 9186533135 |
Fax Number: | 9186472181 |
NPI Enumeration Date: | 09/17/2012 |
NPI Last Update Date: | 09/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YS0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | School |
Taxonomy Definition: |