Individual
HAZEL MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
307 JAMES CIR, RUSSELLVILLE, AR 72801-5829
(479) 880-3682
Mailing address
307 JAMES CIR, RUSSELLVILLE, AR 72801-5829
(479) 880-3682
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P2202000
AR
Other
Enumeration date
12/26/2018
Last updated
03/13/2026
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