Individual
JORDAN PHILIP APPLEGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2003 SE WALTON BLVD, BENTONVILLE, AR 72712-3725
(479) 725-6000
Mailing address
2003 SE WALTON BLVD, BENTONVILLE, AR 72712-3725
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A2102204
AR
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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