Provider Demographics
NPI:1699834531
Name:KELLY-POWELL, DONNA JANELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:JANELLE
Last Name:KELLY-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 1:2706 KIDD DRIVE
Mailing Address - Street 2:
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013
Mailing Address - Country:US
Mailing Address - Phone:817-548-3121
Mailing Address - Fax:
Practice Address - Street 1:301 SOUTH CENTER STREET
Practice Address - Street 2:SUITE 214
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010
Practice Address - Country:US
Practice Address - Phone:817-276-6412
Practice Address - Fax:817-276-6438
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLCSW019031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical