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General NPI Number Information
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NPI Number | 1174310213
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Entity Type | Individual
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Provider Name | ALEXANDRIA POWELL
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Gender |
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 3705 W MEMORIAL RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73134-1512
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Country | US
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Telephone | 866-614-1169
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Fax |
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Provider Business Mailing Address
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Address Line | 1416 TEXAS ST
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City | WOODWARD
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State | OK
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Zip | 73801-3038
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Country | US
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Telephone | 580-377-9681
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB1318988
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License Number State | OK
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