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Individual

STAR HARBOTTLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LAC

Contact information

Practice address
3111 S 70TH ST, FORT SMITH, AR 72903-5017
(479) 452-6650
(479) 452-5847
Mailing address
PO BOX 11818, FORT SMITH, AR 72917-1818
(479) 452-6650
(479) 452-5847

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A2002034
AR
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
02/06/2019
Last updated
02/24/2020
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