Individual
KATI STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31 E CENTER ST STE 209, FAYETTEVILLE, AR 72701-5391
(479) 222-1191
(910) 913-1288
Mailing address
31 E CENTER ST STE 209, FAYETTEVILLE, AR 72701-5391
(479) 222-1191
(910) 713-1288
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
P2204016
AR
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/03/2020
Last updated
11/11/2025
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