Provider Demographics
NPI:1750066270
Name:POWELL, VICTORIA ANNE (RBT)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANNE
Last Name:POWELL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7125 HITT RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-4431
Mailing Address - Country:US
Mailing Address - Phone:251-422-1827
Mailing Address - Fax:
Practice Address - Street 1:7125 HITT RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-4431
Practice Address - Country:US
Practice Address - Phone:251-422-1827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALRBT-23-279930106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALRBT-23-279930OtherREGISTERED BEHAVIORAL TECHNICIAN