Provider Demographics
NPI:1558903062
Name:POWERS, SIDNEY LOUISE
Entity Type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:LOUISE
Last Name:POWERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7675 WOLF RIVER CIR STE 101
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1748
Mailing Address - Country:US
Mailing Address - Phone:901-682-1529
Mailing Address - Fax:901-761-0592
Practice Address - Street 1:7675 WOLF RIVER CIR STE 101
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1748
Practice Address - Country:US
Practice Address - Phone:931-980-8292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1875237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1875OtherTENNESSEE LICENSURE