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Individual

TAYONA Q POWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
916 21ST ST, HUNTINGTON, WV 25703-1812
(304) 939-7068
Mailing address
621 HANDLEY RD, HUNTINGTON, WV 25704-1017
(304) 939-7068

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDC.161830
OH
171M00000X
Case Manager/Care Coordinator
175T00000X
Peer Specialist
WV

Other

Enumeration date
10/26/2020
Last updated
09/21/2023
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