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NPI Code Detail

MEDICARE: KRYSTAL POWELL M.S., CCC-SLP

MEDICARE: KRYSTAL POWELL M.S., 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 PathologistTN

General Provider Information

NPI Number : 1992152888
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRYSTAL POWELL M.S., CCC-SLP
Provider Business Mailing Address
First Line : 220 TOTTY DR
Second Line :
City : HOHENWALD
State : TN
Zip : 38462-2314
Country : US
Telephone Number : 931-628-5627
Fax Number :
Provider Business Practice Location Address
First Line : 5010 TROTWOOD AVE
Second Line :
City : COLUMBIA
State : TN
Zip : 38401-5074
Country : US
Telephone Number : 931-398-6300
Fax Number : 931-840-4402
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2016
Last Update Date : 12/07/2021

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Directions to “ KRYSTAL POWELL M.S., CCC-SLP” Practice Location

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