Individual
MARY CAITLYN CONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
107 N BOSTON PL, RUSSELLVILLE, AR 72801-3940
(479) 219-4100
Mailing address
76 GOLDEN POND DR, RUSSELLVILLE, AR 72802-8122
(479) 567-4744
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
530L
AR
101YM0800X
Mental Health Counselor
A2604014
AR
Other
Enumeration date
04/17/2015
Last updated
05/01/2026
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