Individual
ANNIE E POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3800 S NATIONAL AVE STE 770, SPRINGFIELD, MO 65807
(417) 269-6891
(417) 269-5595
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2005028841
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174529143
—
MO
05
—
499182400
—
MO
01
—
P00419060
RR MEDICARE
—
Enumeration date
06/24/2005
Last updated
06/20/2018
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