Individual
MR. JACK MICHAEL PENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4300 W 7TH ST, ATTN: 122LR, LITTLE ROCK, AR 72205-5446
(501) 257-6734
(501) 257-5071
Mailing address
4300 W 7TH ST, ATTN: 122LR, LITTLE ROCK, AR 72205-5446
(501) 257-6734
(501) 257-5071
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C 213
AR
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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