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Individual

MR. NATHANIEL MENTOR POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1836 FREMONT ST, ASHLAND, OR 97520-2537
(541) 930-2106
Mailing address
201 W MAIN ST STE 4B, MEDFORD, OR 97501-2734

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
06/26/2019
Last updated
06/26/2019
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