Organization
RIVER VALLEY PSYCHOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE A BLANCHARD PH.D. (OWNER)
(479) 567-5654
Entity
Organization
Contact information
Practice address
3101 WEST 2ND CT, RUSSELLVILLE, AR 72801
(479) 567-5654
(479) 567-5661
Mailing address
P.O. BOX 10323, RUSSELLVILLE, AR 72812
(479) 567-5654
(479) 567-5661
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
P1611170
AR
103T00000X
Psychologist
Primary
09-16P
AR
103TC0700X
Clinical Psychologist
09-16P
AR
Other
Enumeration date
06/16/2011
Last updated
01/08/2018
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