Individual
HANNAH BLACKKETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12320 INTERSTATE 30, LITTLE ROCK, AR 72210-7027
(501) 737-4320
Mailing address
12320 INTERSTATE 30, LITTLE ROCK, AR 72210-7027
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/23/2023
Last updated
06/23/2023
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