Individual
LAURA NEEDHAM-PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LPE (NON-INDEPE
Contact information
Practice address
1815 PLEASANT GROVE ROAD, JONESBORO, AR 72405-7870
(870) 933-6886
(870) 933-9395
Mailing address
1815 PLEASANT GROVE ROAD, JONESBORO, AR 72405-7870
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P0305019
AR
103T00000X
Psychologist
11-14E
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178956795
—
AR
01
—
5R806
BCBS
AR
Enumeration date
04/04/2007
Last updated
08/17/2020
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