Individual
MRS. ANDREA PENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3102 SE J ST, BENTONVILLE, AR 72712-3796
(479) 236-1052
Mailing address
1152 GIULIA AVE, SPRINGDALE, AR 72762-3199
(479) 236-1052
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P1412133
AR
Other
Enumeration date
12/31/2014
Last updated
04/21/2023
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