Individual
MISS JACQUELINE NICOLE POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
12014 ROYAL CASTLE CT, CHARLOTTE, NC 28277-3184
(704) 516-3110
(704) 341-6078
Mailing address
12014 ROYAL CASTLE CT, CHARLOTTE, NC 28277-3184
(704) 516-3110
(704) 341-6078
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4913
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7412103
—
NC
Enumeration date
02/06/2007
Last updated
07/08/2007
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