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General NPI Number Information
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NPI Number | 1962365692
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Entity Type | Individual
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Provider Name | ADDISON POWELL
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Gender | Female
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 672 MARINA DR
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City | CHARLESTON
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State | SC
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Zip | 29492-8093
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Country | US
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Telephone | 843-806-3110
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Fax |
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Provider Business Mailing Address
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Address Line | 9204 PINK FROST RD
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City | MONCKS CORNER
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State | SC
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Zip | 29461-9116
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Country | US
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Telephone |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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