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Individual
MS. LISA LEVIDA POWELL
Active
Individual
MS. LISA LEVIDA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
235848
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10
METHADONE CLINIC
CA
Enumeration date
01/16/2019
Last updated
01/16/2019
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