Individual
MRS. KRISTIE DELANE POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
12980 WALSINGHAM RD, LARGO, FL 33774-3511
(727) 900-5129
Mailing address
11125 PARK BLVD STE 104-279, SEMINOLE, FL 33772-4757
(727) 900-5129
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
104100000X
FL
Other
Enumeration date
10/23/2017
Last updated
06/12/2024
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