Individual
HENRY POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSOTR/L
Contact information
Practice address
127 MAIN ST, SOUTH PORTLAND, ME 04106-2647
(207) 619-9239
Mailing address
127 MAIN ST, SOUTH PORTLAND, ME 04106-2647
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3185
ME
Other
Enumeration date
09/14/2016
Last updated
03/22/2017
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