Individual
JOHNNIE DANIEL EZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 W WALNUT ST, SUITE 1500, ROGERS, AR 72756-3521
(479) 636-0083
(479) 636-0144
Mailing address
24 MILLS DR, BELLA VISTA, AR 72714-6333
(479) 466-4004
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P8611021
AR
101YP2500X
Professional Counselor
2021010667
MO
Other
Enumeration date
02/22/2010
Last updated
10/09/2024
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