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Individual

MS. ANDREA T POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1444 KEMPSVILLE RD, VIRGINIA BEACH, VA 23464
(757) 474-7490
(757) 474-7931
Mailing address
PO BOX 5982, VIRGINIA BEACH, VA 23471-0982
(757) 474-7490
(757) 474-7931

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0704009537
VA
225100000X
Physical Therapist
Primary
2305006303
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010378001
VA
05
010378079
VA
05
010378117
VA
05
010378354
VA
05
010378621
VA
05
010378630
VA
Enumeration date
11/29/2005
Last updated
05/15/2020
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