Individual
ISLA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 S MUNN AVE, MARYVILLE, MO 64468-2757
(660) 562-3255
Mailing address
1501 S MUNN AVE, MARYVILLE, MO 64468-2757
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2022038647
MO
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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