Individual
TACHICKA SHAWNTAE MALVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6425 W 12TH ST, LITTLE ROCK, AR 72204-1509
(501) 666-8686
Mailing address
PO BOX 251970, LITTLE ROCK, AR 72225-1970
(501) 666-8686
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/26/2018
Last updated
07/26/2018
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