Individual
MRS. AMANDA MARIE CRISP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CCTP
Contact information
Practice address
115 JEFFERSON ST SW, CAMDEN, AR 71701-3945
(870) 836-8888
(870) 836-8881
Mailing address
602 N. WALTON BLVD., BENTONVILLE, AR 72712
(479) 271-6203
(479) 271-6247
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P1112098
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
MENTAL HEALTH PROFESSIONAL-COUNSELOR
AR
Enumeration date
12/29/2008
Last updated
07/21/2022
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