Provider Demographics
NPI:1053573014
Name:POWERS, JACQUELYN (MS)
Entity type:Individual
Prefix:MS
First Name:JACQUELYN
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 PINE ST FL 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-4102
Mailing Address - Country:US
Mailing Address - Phone:215-349-8141
Mailing Address - Fax:215-349-5314
Practice Address - Street 1:523 PINE ST 1ST FLR
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-4102
Practice Address - Country:US
Practice Address - Phone:215-349-8141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS