Individual
AMY WALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 BRADLEY DR, MOUNTAIN HOME, AR 72653-2730
(870) 424-4021
(870) 424-4112
Mailing address
PO BOX 2533, MOUNTAIN HOME, AR 72654-2533
(870) 424-4021
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
334608795
—
AR
Enumeration date
03/30/2021
Last updated
02/24/2025
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