Individual
MARY LOGAN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAC
Contact information
Practice address
34 W COLT SQUARE DR STE 3, FAYETTEVILLE, AR 72703-2888
(479) 595-0333
Mailing address
3210 AMBERWOOD ST, SPRINGDALE, AR 72762-0512
(501) 680-7199
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A2302005
AR
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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