Individual
RACHEL BANNERT-GODDU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1207 W POPLAR ST, ROGERS, AR 72756-4245
(479) 310-5640
Mailing address
PO BOX 155, ROGERS, AR 72757-0155
(479) 310-5640
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P2002017
AR
101YP2500X
Professional Counselor
P2002017
AR
Other
Enumeration date
06/10/2014
Last updated
12/11/2024
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