Individual
MR. TROY LARRY VINCENT SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
1507 N. PECAN ST., NEWPORT, AR 72112
(870) 523-3643
Mailing address
PO BOX 2306, STATE UNIVERSITY, AR 72467-2306
(870) 258-8116
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A0704036
AR
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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