Provider Demographics
NPI:1922856186
Name:POWELL, MICHELLE (MSED)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:POWELL
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:MUHAMMAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED
Mailing Address - Street 1:4036 BRONXWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-4521
Mailing Address - Country:US
Mailing Address - Phone:646-257-0226
Mailing Address - Fax:
Practice Address - Street 1:4036 BRONXWOOD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-4521
Practice Address - Country:US
Practice Address - Phone:646-257-0226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171R00000XOther Service ProvidersInterpreterGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No1744G0900XOther Service ProvidersSpecialistGraphics Designer
No251300000XAgenciesLocal Education Agency (LEA)
No252Y00000XAgenciesEarly Intervention Provider Agency
No332U00000XSuppliersHome Delivered Meals