Individual
ASHLEY N TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4055 SERAPH DR STE 5, CONWAY, AR 72034-3536
(501) 314-6088
Mailing address
4055 SERAPH DR STE 5, CONWAY, AR 72034-3536
(501) 314-6088
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A2307008
AR
106S00000X
Behavior Technician
RBT-21-184577
AR
Other
Enumeration date
10/12/2022
Last updated
05/16/2024
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