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Individual

SHEALTIEL BLU KUYKENDALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3708 AMBERWOOD ST., SPRINGDALE, AR 72762
(479) 633-4049
Mailing address
1233 W POPLAR ST, ROGERS, AR 72756-4245
(479) 636-9235
(479) 631-0374

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
6690-M
AR
1041C0700X
Clinical Social Worker
Primary
6690-C
AR

Other

Enumeration date
04/12/2016
Last updated
09/09/2020
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