Provider Demographics
NPI:1982465449
Name:POWELL, CHRISTINE CARRINGTON (EDD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CARRINGTON
Last Name:POWELL
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 OLD STONEY LN
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-4900
Mailing Address - Country:US
Mailing Address - Phone:805-750-2019
Mailing Address - Fax:
Practice Address - Street 1:16 OLD STONEY LN
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-4900
Practice Address - Country:US
Practice Address - Phone:805-750-2019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC307799171400000X
VAPGP-515324174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No171400000XOther Service ProvidersHealth & Wellness Coach