Individual
JOLYNN POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
207 STORRS RD, MANSFIELD, CT 06250-0174
(860) 456-4604
(860) 456-1738
Mailing address
PO BOX 174, MANSFIELD, CT 06250-0174
(860) 456-4604
(860) 456-1738
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
001632
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004103305
—
CT
01
—
108475
VALUE OPTIONS
—
01
—
216555
UNITED BEH HEALTH
—
01
—
220926
MHN
—
01
—
C007612
TRICARE
—
01
—
P421340
OXFORD
—
Enumeration date
09/21/2006
Last updated
07/08/2007
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