Healthcare Provider Details

I. General information

NPI: 1891664355
Provider Name (Legal Business Name): DARLENE LORRAINE POWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1597 WASHINGTON PIKE STE B14-132
BRIDGEVILLE PA
15017-2894
US

IV. Provider business mailing address

1597 WASHINGTON PIKE STE B14-132
BRIDGEVILLE PA
15017-2894
US

V. Phone/Fax

Practice location:
  • Phone: 847-309-9304
  • Fax:
Mailing address:
  • Phone: 847-309-9304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-4117118
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: