Individual
MARILYN C PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1500 DODSON AVE, STE 125, FORT SMITH, AR 72901-5182
(479) 573-7960
(479) 573-7961
Mailing address
PO BOX 402319, DS, ATLANTA, GA 30384-2319
(479) 709-7399
(479) 709-7053
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2237-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175035741
—
AR
05
—
200268680A
—
OK
Enumeration date
05/07/2008
Last updated
08/27/2010
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