MEDICARE: MISS KENYA POWELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1487382511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KENYA POWELL

Provider Business Mailing Address
First Line	:	405 W GREENLAWN AVE STE 200
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48910-2889
Country	:	US
Telephone Number	:	517-974-5016
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 W GREENLAWN AVE STE 200
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48910-2889
Country	:	US
Telephone Number	:	517-974-5016
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2022
Last Update Date	:	03/12/2026

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Directions to “ MISS KENYA POWELL ” Practice Location

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