Individual
CHARIS RENEE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
13807 INDIANA AVE, LUBBOCK, TX 79423-1783
(806) 993-2300
Mailing address
13807 INDIANA AVE, LUBBOCK, TX 79423-1783
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NMJ840015547
PPO
NM
Enumeration date
09/01/2016
Last updated
05/17/2024
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