Individual
PENNY GOODS POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
3314 HWY 594 LOT 16, MONROE, LA 71203
(318) 953-3610
Mailing address
3314 HWY 594 LOT 16, MONROE, LA 71203
(318) 953-3610
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13376
LA
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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