Individual
JACKIE WARDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17262 HEAVY CHEVY RD, SILOAM SPRINGS, AR 72761-5382
(479) 220-9626
Mailing address
17262 HEAVY CHEVY RD, SILOAM SPRINGS, AR 72761-5382
(479) 220-9626
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/08/2014
Last updated
03/31/2016
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