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Individual

KEVIN LAVELLE BARNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1628 E PAGE AVE, MALVERN, AR 72104
(501) 315-3344
Mailing address
PO BOX 1589, BENTON, AR 72018-1589
(501) 315-3344
(870) 534-5798

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
8667-M
AR
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary
8667-C
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
116378726
AR
Enumeration date
05/08/2012
Last updated
11/23/2020
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