Individual
MRS. SUSANNA LORRAINE AICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
915 OAK ST STE 103, CONWAY, AR 72032-4389
(501) 725-1163
Mailing address
59 SOUTHLAND CT, MAUMELLE, AR 72113-6262
(501) 391-2793
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8424-C
AR
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
07/21/2015
Last updated
09/10/2020
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