Individual
MYRNA BORBON YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
130 E POPLAR ST STE C&D, FAYETTEVILLE, AR 72703
(479) 435-6047
(479) 755-3595
Mailing address
130 E POPLAR ST STE C&D, FAYETTEVILLE, AR 72703-2532
(479) 435-6047
(479) 755-3595
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A0507049
AR
101YM0800X
Mental Health Counselor
P0807060
AR
101YP2500X
Professional Counselor
Primary
P0807060
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207210719
—
AR
Enumeration date
06/05/2006
Last updated
05/29/2018
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