Individual
JANICE CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
11 CHILDRENS WAY # 401, LITTLE ROCK, AR 72202-3500
(501) 364-3810
(501) 364-3416
Mailing address
11 CHILDRENS WAY # 401, LITTLE ROCK, AR 72202-3500
(501) 364-3810
(501) 364-3416
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
92-1P
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141633001
—
AR
Enumeration date
10/13/2006
Last updated
01/07/2011
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