Individual
DR. KAORU A POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1444 MANSFIELD AVE, MISSOULA, MT 59812-9794
(406) 219-5938
Mailing address
201 TYLER WAY, LOLO, MT 59847-9794
(808) 228-9086
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY-PSY-LIC-4549
MT
Other
Enumeration date
08/24/2020
Last updated
10/10/2023
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