Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 8869 | MA |
N | 103G00000X | Clinical Psychologist | 8869 | MA |
N | 103TC0700X | Clinical Psychologist | 8869 | MA |
Y | 103TH0100X | Health Service | 8869 | MA |
NPI | 1528221793 |
---|---|
Provider Name | Dr. Jean Winnifred Powell |
First Address | Fall River, MA 02720-2132 |
Second Address | Fall River, MA 02720-2132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2008 |
Last Update Date | 06/01/2009 |