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Individual

CHRISTIAN L POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6019 BELFAST DR, AUSTIN, TX 78723-1832
(979) 595-6947
Mailing address
1174 OAKGROVE AVE, AUSTIN, TX 78702-2521
(979) 595-6947

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
80949
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
80949
LPC INTERN
TX
Enumeration date
01/27/2019
Last updated
01/27/2019
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