Individual
VIRGINIA LYNN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1101 MORGAN ST, SUITE 8, PARAGOULD, AR 72450-3949
(870) 335-9483
(870) 335-9487
Mailing address
1815 PLEASANT GROVE RD, JONESBORO, AR 72401-7870
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6221-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171642795
—
AR
01
—
5BA66
BCBS
AR
Enumeration date
08/23/2010
Last updated
05/09/2018
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