Provider Demographics
NPI:1639512585
Name:POWERS, ALLISON FOX
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:FOX
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 1:8200 FLOURTOWN AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038-7969
Mailing Address - Country:US
Mailing Address - Phone:215-233-3994
Mailing Address - Fax:215-233-3997
Practice Address - Street 1:8200 FLOURTOWN AVE STE 8
Practice Address - Street 2:
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038-7969
Practice Address - Country:US
Practice Address - Phone:215-233-3994
Practice Address - Fax:215-233-3997
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000701106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist