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Individual

DR. MARA ELIZABETH WHITESIDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
2575 S. GENE GEORGE BLVD., STE. 100, SPRINGDALE, AR 72762
(479) 750-0125
Mailing address
2575 S. GENE GEORGE BLVD, STE. 100, SPRINGDALE, AR 72762
(479) 750-0125

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
17-24P
AR
103T00000X
Psychologist
17-24P
AR
103TS0200X
School Psychologist
17-24P
AR

Other

Enumeration date
05/24/2018
Last updated
01/09/2024
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