Organization
PSYCHOLOGY CENTER OF RUSSELLVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTINA LIN COUCH PSYD (OWNER)
(479) 219-5041
Entity
Organization
Contact information
Practice address
2621 W MAIN ST, SUITE 7, RUSSELLVILLE, AR 72801-2534
(479) 219-5041
(479) 219-5046
Mailing address
2621 W MAIN ST, SUITE 7, RUSSELLVILLE, AR 72801-2534
(479) 219-5041
(479) 219-5046
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
12-01P
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191430719
—
AR
Enumeration date
06/12/2015
Last updated
06/12/2015
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