Individual
HEATHER POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
730 SW 4TH ST STE 6, CAPE CORAL, FL 33991-1984
(239) 910-0712
Mailing address
730 SW 4TH ST STE 6, CAPE CORAL, FL 33991-1984
(239) 910-0712
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0-19-10015
FL
106E00000X
Assistant Behavior Analyst
Primary
0-19-10015
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114226200
—
FL
Enumeration date
06/20/2019
Last updated
08/09/2022
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