Individual
ALTERA REASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 W BROADWAY ST STE G18, NORTH LITTLE ROCK, AR 72114-5541
(501) 550-8792
(501) 285-8321
Mailing address
201 W BROADWAY ST STE G18, NORTH LITTLE ROCK, AR 72114-5541
(501) 550-8792
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
7153-C
AR
1041C0700X
Clinical Social Worker
Primary
7153-C
AR
Other
Enumeration date
01/26/2022
Last updated
03/27/2022
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