Organization
TRACY TULLOS SOUTHERN THERAPY SPECIALISTS
Active
Organization
TRACY TULLOS SOUTHERN THERAPY SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY TULLOS LCSW (OWNER)
(479) 576-2799
Entity
Organization
Contact information
Practice address
701 E MAIN ST, SUITE 2, RUSSELLVILLE, AR 72801-5247
(479) 576-2799
Mailing address
PO BOX 9178, RUSSELLVILLE, AR 72811-9178
(479) 498-6750
(479) 968-1673
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/25/2015
Last updated
10/28/2015
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