Individual
MRS. EYDIE NERISSA CANTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
18 COUNTY ROAD 458, CHILD AND YOUTH PEDIATRIC DAY CLINIC, MOUNTAIN HOME, AR 72653-8212
(870) 425-5252
(870) 425-5254
Mailing address
18 COUNTY ROAD 458, MOUNTAIN HOME, AR 72653-8212
(870) 425-5252
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A0607043
AR
Other
Enumeration date
02/05/2007
Last updated
09/03/2009
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