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NPI Code Detail

MEDICARE: MRS. SELAH J POWELL CCC-SLP

MEDICARE: MRS. SELAH J POWELL CCC-SLP
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
1235Z00000XSpeech-Language Pathologist181017AK

General Provider Information

NPI Number : 1770256877
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SELAH J POWELL CCC-SLP
Provider Business Mailing Address
First Line : 6710 ROUND TREE DR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-7017
Country : US
Telephone Number : 907-440-4354
Fax Number :
Provider Business Practice Location Address
First Line : 1130 W DIMOND BLVD STE B
Second Line :
City : ANCHORAGE
State : AK
Zip : 99515-1511
Country : US
Telephone Number : 907-229-8933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2021
Last Update Date : 07/26/2021

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