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Individual

SHANTELL ALEXANDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PLMSW

Contact information

Practice address
620 S LAUREL ST, PINE BLUFF, AR 71601-4859
(870) 534-4900
Mailing address
620 S LAUREL ST, PINE BLUFF, AR 71601-4859
(870) 534-4900

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
180635526
AR
Enumeration date
09/17/2014
Last updated
09/17/2014
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