Provider Demographics
NPI:1043799190
Name:POWDRILL, KAREN YVONNE
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:YVONNE
Last Name:POWDRILL
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 1:4 ALLEGHENY CTR FL 8
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5256
Mailing Address - Country:US
Mailing Address - Phone:412-330-4000
Mailing Address - Fax:
Practice Address - Street 1:4 ALLEGHENY CTR FL 8
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5256
Practice Address - Country:US
Practice Address - Phone:412-330-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020437103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD38-3876389Medicaid