Individual
TERRIE CANTERBURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1655 FENDLEY RD, BISMARCK, AR 71929-6029
(501) 802-7416
Mailing address
1655 FENDLEY RD, BISMARCK, AR 71929-6029
(501) 802-7416
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
AR
104100000X
Social Worker
Primary
1134243579
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134243579
—
AR
Enumeration date
08/14/2014
Last updated
08/14/2014
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