Individual
JACK L. POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW-C
Contact information
Practice address
310 GAY ST, LOWER LEVEL, CAMBRIDGE, MD 21613-1898
(410) 228-7714
(410) 228-8049
Mailing address
310 GAY ST, LOWER LEVEL, CAMBRIDGE, MD 21613-1898
(410) 228-7714
(410) 228-8049
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
08358
MD
Other
Enumeration date
04/16/2008
Last updated
02/24/2010
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