Individual
JOSHUA BASSAREAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLMSW
Contact information
Practice address
4253 N CROSSOVER RD, FAYETTEVILLE, AR 72703-4593
(479) 443-6496
Mailing address
85 N LETITIA AVE, FAYETTEVILLE, AR 72701
(603) 831-3413
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073982658
—
UT
Enumeration date
09/24/2015
Last updated
07/06/2017
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