Individual
BETTY LEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHPP
Contact information
Practice address
1825 E BROADWAY ST, FORREST CITY, AR 72335-3409
(870) 630-2328
(870) 630-2348
Mailing address
252 MANOR ST, MARION, AR 72364-1936
(870) 739-6818
(870) 739-6821
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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