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General NPI Number Information
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NPI Number | 1952865651
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Entity Type | Individual
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Provider Name | CHRISTIAN L POWELL
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Gender | Male
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Dates
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Enumeration Date | 01/27/2019
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Last Update Date | 01/27/2019
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Provider Practice Location Address
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Address Line | 6019 BELFAST DR
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City | AUSTIN
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State | TX
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Zip | 78723-1832
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Country | US
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Telephone | 979-595-6947
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Fax |
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Provider Business Mailing Address
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Address Line | 1174 OAKGROVE AVE
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City | AUSTIN
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State | TX
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Zip | 78702-2521
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Country | US
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Telephone | 979-595-6947
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 80949
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License Number State | TX
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