Individual
DANIEL WALLACE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
546 S ELIZABETH ST APT 2, SALT LAKE CITY, UT 84102-3822
(801) 666-9061
Mailing address
546 S ELIZABETH ST APT 2, SALT LAKE CITY, UT 84102-3822
(801) 666-9061
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
12/02/2011
Last updated
01/29/2021
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