Individual
KIMBERLY R ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
307 CARPENTER DAM RD STE B, HOT SPRINGS, AR 71901-8282
(501) 781-2230
(888) 816-7916
Mailing address
201 S ROSE ST, SHERIDAN, AR 72150-2451
(870) 917-2171
(870) 917-2161
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A0909102
AR
Other
Enumeration date
03/02/2009
Last updated
07/19/2018
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