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1104005693
GLEN VICTOR POWELL
LEOMINSTER, MA
NPI
1104005693
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2007-10-31
Last Update Date
2007-10-31
Business Address
-- GLEN VICTOR POWELL M.S.
100 ERDMAN WAY
LEOMINSTER, MA 01453-1804
Phone number: 978-537-0956
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Mailing Address
-- GLEN VICTOR POWELL M.S.
20 OLDE COLONIAL DR APT 6
GARDNER, MA 01440-4212
Phone number: 978-273-8438
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