Individual
KATHLEEN POWERS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
65 OLD SPRINGFIELD RD, LEBANON, KY 40033-9185
(270) 692-2509
(270) 692-2592
Mailing address
107 CRANES ROOST CT, ELIZABETHTOWN, KY 42701-3650
(270) 765-2605
(270) 766-1222
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0400
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11574930
CAQH
—
05
—
30605018
—
KY
Enumeration date
06/07/2006
Last updated
07/08/2007
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