Individual
RANDALL STUART POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
ONE BALA AVENUE, SUITE 305, BALA CYNWYD, PA 19004
(610) 667-4652
(610) 667-6418
Mailing address
224 VALLEY RD, MERION STATION, PA 19066
(610) 667-4652
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
DS004364L
PA
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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