Individual
LAKISHA F STUCKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
829 HALBERT ST, MALVERN, AR 72104-2607
(501) 332-4400
Mailing address
829 HALBERT ST, MALVERN, AR 72104-2607
(501) 332-4400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A2002017
AR
101YM0800X
Mental Health Counselor
Primary
P2209012
AR
171M00000X
Case Manager/Care Coordinator
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Other
Enumeration date
02/20/2007
Last updated
09/27/2022
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