Individual
PAYTON POWERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA CCC-SLP
Contact information
Practice address
4075 PARK AVE, MEMPHIS, MEMPHIS, TN 38152
(901) 282-9090
Mailing address
102 CLARK PL APT 1, MEMPHIS, TN 38104-2419
(901) 282-9090
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7398
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7398
SLP TN STATE LICENSE
TN
Enumeration date
03/29/2022
Last updated
10/28/2022
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