Individual
ANTONINA LAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHPP
Contact information
Practice address
829 HALBERT ST, MALVERN, AR 72104-2607
(501) 332-4400
(501) 332-4403
Mailing address
829 HALBERT ST, MALVERN, AR 72104-2607
(501) 332-4400
(501) 332-4403
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/04/2007
Last updated
10/04/2007
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