Individual
WILLIETTE POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICDC
Contact information
Practice address
13422 KINSMAN RD, CLEVELAND, OH 44120-4410
(216) 283-4400
(216) 283-5359
Mailing address
18400 E PARK DR, CLEVELAND, OH 44119-2057
(216) 283-4400
(216) 283-5359
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
S.1700304
OH
251S00000X
Community/Behavioral Health Agency
161339
OH
Other
Enumeration date
02/10/2017
Last updated
10/08/2020
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