Healthcare Provider Details

I. General information

NPI: 1316287360
Provider Name (Legal Business Name): CONSTANCE N POWELL M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2013
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 HIGHWAY 7 S
OXFORD MS
38655-5392
US

IV. Provider business mailing address

9851 HIGHWAY 178 STE A
OLIVE BRANCH MS
38654-3214
US

V. Phone/Fax

Practice location:
  • Phone: 662-234-7521
  • Fax:
Mailing address:
  • Phone: 662-253-8324
  • Fax: 662-253-8336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: