Individual
GREGORY JAVON POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BHRS
Contact information
Practice address
206 CROSSWINDS DR, RAEFORD, NC 28376-7502
(919) 438-9125
Mailing address
206 CROSSWINDS DR, RAEFORD, NC 28376-7502
(919) 438-9125
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
OK
Other
Enumeration date
12/29/2011
Last updated
12/29/2011
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