Individual
KATIE LYNN POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
338 BROADWAY ST STE 301, CAPE GIRARDEAU, MO 63701-7331
(573) 579-1787
Mailing address
807 NOTRE DAME DR, O FALLON, MO 63366-1785
(636) 544-5303
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2020024884
MO
Other
Enumeration date
08/05/2020
Last updated
08/05/2020
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