Individual
CAROLSHENE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 WEST 100 NORTH, PRICE, UT 84501-3102
(435) 637-2358
(435) 637-9141
Mailing address
105 WEST 100 NORTH, PO BOX 867, PRICE, UT 84501
(435) 637-7200
(435) 637-2377
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5617259-3503
UT
Other
Enumeration date
09/09/2011
Last updated
09/16/2011
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