Individual
STACI YVONNE DUVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., LPC
Contact information
Practice address
1021 E POPLAR ST, CLARKSVILLE, AR 72830-4428
(479) 754-8610
(479) 754-8788
Mailing address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020
(479) 750-4843
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
P1503016
AR
101YP2500X
Professional Counselor
Primary
P1503016
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227034719
—
AR
Enumeration date
09/19/2011
Last updated
04/30/2020
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