Individual
ALISSA LOREN BERRUQUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1312 W COLLIN RAYE DR, DE QUEEN, AR 71832-2135
(870) 548-7115
(870) 642-3388
Mailing address
2904 ARKANSAS BLVD, TEXARKANA, AR 71854-2536
(870) 773-4655
(870) 772-4650
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/27/2017
Last updated
12/27/2017
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