Provider Demographics
NPI:1972180206
Name:POWELL, GLINDA ANN (SOCIAL WORK/ABD)
Entity Type:Individual
Prefix:MS
First Name:GLINDA
Middle Name:ANN
Last Name:POWELL
Suffix:
Gender:F
Credentials:SOCIAL WORK/ABD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 342
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70063-0342
Mailing Address - Country:US
Mailing Address - Phone:323-632-3991
Mailing Address - Fax:
Practice Address - Street 1:2200 38TH ST APT A
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-3572
Practice Address - Country:US
Practice Address - Phone:323-632-3991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-24
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator