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Individual

MONICA THEOBALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.P.C.

Contact information

Practice address
905 MCAFEE MEDICAL CIRCLE, BEEBE, AR 72012-2217
(501) 232-2600
(501) 242-0820
Mailing address
905 MCAFEE MEDICAL CIRCLE, BEEBE, AR 72012-2217
(501) 232-2600
(501) 242-0820

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P1607065
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
195508795
AR
01
5CB88
BCBS
AR
Enumeration date
02/05/2013
Last updated
01/29/2020
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