Powell, Willie J

Powell, Willie J is an individual health care provider with primary practice located at 2844 Traceland Dr , Tupelo MS 38801-4200. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant, which is considered as his primary health care specialty. Powell, Willie J can be contacted via phone (662) 680-3148.

Contact Information

Primary practice address
2844 Traceland Dr Tupelo MS 38801-4200
Phone: (662) 680-3148
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant 224Z00000X TA2611 Mississippi

Profile Details

NPI number 1346507787
LBN Legal business name Powell, Willie J
Credentials COTA/L
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2012
Last updated Apr 23rd, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1346507787 NPPES
Mississippi Other 314000000X BLUE CROSS BLUE SHIELD

Popular Providers