Organization
THERAPY ASSESSMENT CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMANTHA SEWELL SHORT PSYD., LP (LICENSED PSYCHOLOGIST)
(501) 291-3091
Entity
Organization
Contact information
Practice address
317 OAK ST STE 3, CONWAY, AR 72032
(501) 291-3091
(501) 588-0484
Mailing address
317 OAK ST STE 3, CONWAY, AR 72032-5679
(501) 291-3091
(501) 588-0484
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Enumeration date
09/17/2015
Last updated
09/06/2019
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