Individual
MICHELLE RENEE PASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC,LMFT
Contact information
Practice address
420 N MAIN ST, GREENWOOD, AR 72936
(479) 996-8884
Mailing address
PO BOX 11818, FORT SMITH, AR 72917-1818
(479) 452-6650
(479) 452-5847
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A1007071
AR
101YP2500X
Professional Counselor
Primary
P1306054
AR
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
A1008019
AR
106H00000X
Marriage & Family Therapist
M1306007
AR
Other
Enumeration date
10/06/2008
Last updated
05/16/2018
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