Individual
MR. RONALD ELLIS POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
344 E 100 S, SALT LAKE CITY, UT 84111-1700
(800) 322-3222
Mailing address
5965 S 900 E, SALT LAKE CITY, UT 84121-1720
(801) 263-7100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
111182-6006
UT
101YM0800X
Mental Health Counselor
6220020-3503
UT
Other
Enumeration date
12/05/2008
Last updated
09/13/2018
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