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Individual

DR. MARK POWLESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1711 S 11TH ST, MILWAUKEE, WI 53204-3310
(414) 383-9526
(414) 469-2719
Mailing address
6850 SOUTH DORY DRIVE, FRANKLIN, WI 53132
(414) 828-1645

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
380260
WI
103TC0700X
Clinical Psychologist
Primary
2967-57
WI

Other

Enumeration date
10/17/2011
Last updated
09/09/2014
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