NPI Code Details Logo

NPI 1417842428

NPI 1417842428 : JILLIAN POWLOWSKI : ATHENS, OH

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1417842428
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    JILLIAN POWLOWSKI
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/10/2025
-----------------------------------------------------
    Last Update Date     |    06/10/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    400 E STATE ST STE D 
-----------------------------------------------------
    City                 |    ATHENS
-----------------------------------------------------
    State                |    OH
-----------------------------------------------------
    Zip                  |    45701-1870
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    740-326-6110
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    958 KICKAPOO AVE 
-----------------------------------------------------
    City                 |    AKRON
-----------------------------------------------------
    State                |    OH
-----------------------------------------------------
    Zip                  |    44305-1210
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    104100000X
-----------------------------------------------------
    Taxonomy Name        |    Social Worker
-----------------------------------------------------
    License Number       |    S.0031298
-----------------------------------------------------
    License Number State |    OH
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.