Individual
DESHAI POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HAB, FST
Contact information
Practice address
9135 N MERIDIAN ST STE B8, INDIANAPOLIS, IN 46260-1816
(317) 750-5189
Mailing address
9135 N MERIDIAN ST STE B8, INDIANAPOLIS, IN 46260-1816
(317) 750-5189
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
000000
IN
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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