Individual
ALLIE TRAIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
204 MISSISSIPPI ST S, WYNNE, AR 72396-3025
(870) 208-8499
(870) 208-8044
Mailing address
39 SOUTHRIDGE CIR, WYNNE, AR 72396-8064
(870) 318-6551
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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