MI'TALIA SHANICE POWELL

DAYTONA BEACH, FL
NPI1891313516
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
(Licence: FL  CBHCMP101944)
Additional Taxonomies106S00000X Behavior Technician
Enumeration Date2020-07-09
Last Update Date2021-07-01
Business Address
MI'TALIA SHANICE POWELL BS
841 JIMMY ANN DR
DAYTONA BEACH, FL 32117-4583
Phone number: 386-425-3900
Mailing Address
MI'TALIA SHANICE POWELL BS
841 JIMMY ANN DR
DAYTONA BEACH, FL 32117-4583
Phone number: 386-425-3900