Individual
MR. KENYON MARK MOSHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, LADAC
Contact information
Practice address
2503 PINE ST STE 4, ARKADELPHIA, AR 71923-4368
(870) 403-3769
(877) 276-1301
Mailing address
2503 PINE ST STE 4, ARKADELPHIA, AR 71923-4368
(870) 403-3769
(877) 276-1301
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P1106034
AR
101YM0800X
Mental Health Counselor
P110604
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231767719
—
AR
01
—
NONE
NONE
—
Enumeration date
09/03/2009
Last updated
08/12/2021
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