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Individual

FONDA KAY MAUPIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MHP

Contact information

Practice address
706 S MAIN ST STE 2, MOUNTAIN HOME, AR 72653-4458
(870) 501-7101
(501) 203-0909
Mailing address
PO BOX 2818, MOUNTAIN HOME, AR 72654-2818
(417) 350-0196
(501) 203-0909

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1174771091
AR
05
174413795
AR
Enumeration date
09/04/2008
Last updated
04/28/2026
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