Provider Demographics
NPI:1659335073
Name:POWELL, CAROL WHITCOMB (PHD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:WHITCOMB
Last Name:POWELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5147 N 9TH AVE STE 315
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8794
Mailing Address - Country:US
Mailing Address - Phone:850-473-0112
Mailing Address - Fax:850-473-0118
Practice Address - Street 1:5149 N 9TH AVE
Practice Address - Street 2:STE 315
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504
Practice Address - Country:US
Practice Address - Phone:850-473-0112
Practice Address - Fax:850-473-0118
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY142231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist