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Individual

JILL RENEE BEACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAC

Contact information

Practice address
DELTA BEHAVIORAL HEALTH, LLC, 920 E. MEDICAL DRIVE, MANILA, AR 72442
(870) 570-0358
(870) 570-0359
Mailing address
P.O. BOX 717, MANILA, AR 72442
(870) 570-0358
(870) 570-0359

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A2412004
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
283638795
AR
Enumeration date
05/02/2022
Last updated
01/08/2025
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