Individual
MRS. MARYKAY POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADDICTIONS COUNSELOR
Contact information
Practice address
1917 E PLEASANT VALLEY BLVD, ALTOONA, PA 16602-7552
(814) 201-2355
(814) 201-2355
Mailing address
128 57TH ST, ALTOONA, PA 16602-5002
(814) 937-6889
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20-05-16
OR
175T00000X
Peer Specialist
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-05-16
MHACBO
OR
Enumeration date
03/11/2015
Last updated
08/07/2023
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