Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | NA | DC |
Y | 101YP2500X | Professional Counselor | PRC14017 | DC |
NPI | 1154606267 |
---|---|
Provider Name | Dr. Edwin Witt Powell |
First Address | Washington, DC 20012-1049 |
Second Address | Washington, DC 20059-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2011 |
Last Update Date | 20/10/2011 |