Individual
JENNIFER POWELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10445 DUPONT OAKS BLVD, FORT WAYNE, IN 46845-8792
(260) 471-4770
Mailing address
18126 LINCOLN HWY E, MONROEVILLE, IN 46773-9788
(260) 348-0632
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001187A
IN
Other
Enumeration date
11/13/2014
Last updated
11/13/2014
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