Individual
MISS ABIGAIL EMILY ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHPP
Contact information
Practice address
3715 N BUSINESS DR STE 104, FAYETTEVILLE, AR 72703-5287
(479) 521-1532
Mailing address
3715 N BUSINESS DR STE 104, FAYETTEVILLE, AR 72703-5287
(479) 521-1532
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
AR
Other
Enumeration date
08/30/2016
Last updated
08/30/2016
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