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Individual

ELENA MARIA LAINEZ ZACARIAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
350 SALEM RD, CONWAY, AR 72034-7525
(501) 336-8300
Mailing address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A2401030
AR
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
259077795
AR
Enumeration date
12/16/2020
Last updated
03/05/2024
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