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Individual

MR. LD BARNEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LADC, LADAC, SAP

Contact information

Practice address
39 DEVIZIS DR, BELLA VISTA, AR 72714-3820
(479) 268-4823
Mailing address
39 DEVIZIS DR, BELLA VISTA, AR 72714-3820
(479) 268-4823

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
342
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0285L
LADAC
AR
01
342
LICENSED ALCOHOL AND DRUG COUNSELOR
OK
Enumeration date
01/18/2009
Last updated
04/23/2015
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