Individual
MS. GELETTA PHILAE SHAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 COX ST, BENTON, AR 72015-4611
(501) 906-4250
Mailing address
1600 ALDERSGATE RD STE 200, LITTLE ROCK, AR 72205-6676
(501) 661-0720
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8360C
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
AR
Other
Enumeration date
08/12/2013
Last updated
01/22/2020
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