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1215163316
BENNY LEE POWELL
FORT WAYNE, IN
NPI
1215163316
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IN 87000082A)
Enumeration Date
2009-06-03
Last Update Date
2010-10-26
Business Address
-- BENNY LEE POWELL MDiv, LCAC
2100 GOSHEN RD
FORT WAYNE, IN 46808-1493
Phone number: 240-471-3500
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Mailing Address
-- BENNY LEE POWELL MDiv, LCAC
850 N HARRISON ST ATTN: ANNE LAWSON - CREDENTIALING
WARSAW, IN 46580-3163
Phone number: 574-267-7169
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