Individual
SUSAN GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18 COUNTY ROAD 458, MOUNTAIN HOME, AR 72653-8212
(870) 425-5252
Mailing address
18 COUNTY ROAD 458, MOUNTAIN HOME, AR 72653-8212
(870) 425-5252
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
PLMSW
AR
Other
Enumeration date
11/13/2014
Last updated
11/13/2014
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