Individual
DESTINY WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6501 W 12TH ST, LITTLE ROCK, AR 72204-1511
(501) 666-8686
Mailing address
PO BOX 251970, LITTLE ROCK, AR 72225-1970
(501) 666-8686
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
AR
Other
Enumeration date
07/03/2014
Last updated
07/03/2014
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