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Individual

MR. TIMOTHY MARK CUPPLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CIT

Contact information

Practice address
310 MID CONTINENT PLZ, 6TH FLOOR SUITE 602, WEST MEMPHIS, AR 72301-1760
(870) 735-2499
(870) 735-2496
Mailing address
310 MID CONTINENT PLZ, 6TH FLOOR SUITE 602, WEST MEMPHIS, AR 72301-1760
(870) 735-2499
(870) 735-2496

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
07/07/2011
Last updated
07/07/2011
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