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General NPI Number Information
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NPI Number | 1962226274
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Entity Type | Individual
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Provider Name | ERMAL GRACE KATHLEEN POWELL L.AC, DACM
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Gender | Female
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 6040 COMMERCE BLVD
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City | ROHNERT PARK
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State | CA
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Zip | 94928-2181
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Country | US
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Telephone | 707-559-7500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 816
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City | BOLINAS
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State | CA
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Zip | 94924
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Country | US
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Telephone | 619-886-7029
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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