Individual
JENNIFER POWELL NORTHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 ALDERSGATE RD, LITTLE ROCK, AR 72205-6620
(501) 821-5459
Mailing address
2740 COLLEGE AVE, CONWAY, AR 72034-6141
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-16-22612
—
235Z00000X
Speech-Language Pathologist
Primary
SP#2803
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162049721
—
AR
Enumeration date
04/13/2010
Last updated
08/22/2016
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