Individual
KIMBERLY R WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
109 S LAREDO AVE, SUITE 2, RUSSELLVILLE, AR 72801-4853
(479) 280-8113
(479) 431-5014
Mailing address
109 S LAREDO AVE, SUITE 2, RUSSELLVILLE, AR 72801-4853
(479) 280-8113
(479) 431-5014
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P2206000
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P2206000
STATE
AR
Enumeration date
07/06/2021
Last updated
02/13/2025
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