Individual
THEA DAVID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC/LAMFT
Contact information
Practice address
5210 W VILLAGE PKWY, ROGERS, AR 72758-8104
(479) 282-4452
Mailing address
5210 W VILLAGE PKWY, ROGERS, AR 72758-8104
(479) 282-4452
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A2201004
AR
Other
Enumeration date
02/04/2025
Last updated
02/04/2025
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