Individual
KEEGAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2703 SE OTIS CORLEY DR STE 11, BENTONVILLE, AR 72712-3414
(479) 339-9678
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-335928
AR
Other
Enumeration date
04/05/2024
Last updated
04/05/2024
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