Organization
CLINICAL PSYCHOLOGY FOR HEALTH AND PERFORMANCE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITRA S. FAY PH.D. (PRESIDENT)
(479) 667-1217
Entity
Organization
Contact information
Practice address
3401 ROGERS AVE STE B, FORT SMITH, AR 72903-2986
(479) 242-4560
Mailing address
11347 HONEYSUCKLE RD, OZARK, AR 72949-9676
(479) 667-1217
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
82-01P
AR
Other
Enumeration date
03/05/2012
Last updated
03/05/2012
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