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General NPI Number Information
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NPI Number | 1528221793
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Entity Type | Individual
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Provider Name | JEAN WINNIFRED POWELL PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 12/26/2023
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Provider Practice Location Address
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Address Line | 2779 N MAIN ST 1 REAR
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City | FALL RIVER
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State | MA
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Zip | 02720-1521
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Country | US
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Telephone | 508-673-3133
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Fax | 508-916-3742
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Provider Business Mailing Address
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Address Line | 2779 N MAIN ST 1 REAR
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City | FALL RIVER
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State | MA
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Zip | 02720-1521
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Country | US
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Telephone | 508-673-3133
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Fax | 508-916-3742
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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 | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | 8869
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 8869
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | 8869
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License Number State | MA
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