Individual
MRS. KEISHA MARIE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4171 N CROSSOVER RD, FAYETTEVILLE, AR 72703-4591
(479) 575-9471
Mailing address
4171 N CROSSOVER RD, FAYETTEVILLE, AR 72703-4591
(479) 575-9471
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/17/2011
Last updated
04/17/2011
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