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Individual

MICHELLE DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
4323 JEFFERSON AVE, TEXARKANA, AR 71854-1515
(870) 773-0700
Mailing address
505 W GRAND AVE, HOT SPRINGS, AR 71901-3931
(501) 623-3700

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YP2500X
Professional Counselor
Primary
P1802016
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
225255795
AR
Enumeration date
09/03/2015
Last updated
02/11/2019
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